- 期刊
一位罹患口腔癌病人接受皮瓣重建術之護理經驗
Nursing Experience of a Patient Suffering from Oral Cancer Undergoing Skin Flap Reconstruction
摘要
本文描述一位罹患口腔癌病人行廣泛性切除術併皮瓣重建術後之照護經驗。護理期間為2020年11月12日至11月20日，運用Gordon十一項健康功能型態評估方法，使用觀察、筆談與直接照護、身體評估及查閱病歷等方式蒐集資料。發現個案出現急性疼痛、口腔黏膜改變及身體心像改變等健康問題。筆者在護理期間主動關懷建立信任護病關係，定時給予止痛藥物及適時轉移注意力以緩解術後傷口疼痛不適；提供口腔護理減少異味及牙菌斑增生，促進口腔組織黏膜的修復；引導個案抒發身體外觀改變之感受，進而能坦然接受疾病，增進自信及自我照顧能力，強化正向因應行為，緩解個案因為治療帶來的不安與衝擊。將此照護經驗分享提供臨床人員照護口腔癌經顏面重建術後病患之參考。建議往後照護類似此個案，及早透過跨團隊合作及相關支持團體介入，幫助個案勇敢面對疾病，配合完成治療，早日重返家庭及融入社會生活。
並列摘要
This article described the nursing experience of a male patient suffering from first diagnosed oral cancer who underwent extensive resection and flap reconstruction. The nursing period of care was from November 12 to November 20, 2020. Through direct care, in-depth interviews, physical assessments, and written conversations, major health problems were identified after the surgery, including: acute pain, changes in oral mucosa, and changes in body image; Gordon's eleven health function patterns were applied with retrospective investigations on medical records to collect information. During the nursing period, the author took the initiative to establish a trust-care relationship, regularly administer analgesics, and properly divert attention to relieve postoperative wound pain and ease discomfort. Cancer specific oral care was provided to reduce odor and dental plaque proliferation in order to repair oral tissue mucosa. In addition, strategies were used to guide the patient to express feelings about body appearance changes, cope with the disease, increase self-confidence and self-care ability, adjust negative emotions and strengthen positive response behaviors, with the aim to alleviate cancer related anxiety and treatment impact. For patients who encounter similar situations, we recommend to intervene as early as possible; cross-team personnel and oral cancer patient support groups would encourage these patients not only completing the cancer treatment but also facilitate them returning to their family with better, integrated social life.