本文係照顧一位53歲女性,因卵巢癌第三期合併腹水入院,個案面臨手術後傷口造成的急性疼痛,以及因對卵巢癌疾病,還有手術預後的不確定感,產生負面情緒造成個人因應壓力失調,加上照顧者案夫於個案住院期間,對於照顧原則重點的不熟悉,顯示出照顧者角色緊張等問題,以上都造成個案的身心衝擊。筆者於2017年3月22日至2017年4月7日護理期間,採Gordon十一項功能性健康型態評估,運用觀察、會談、身體評估及病歷查閱等方式,收集主客觀資料,在整個護理期間,提供個別性、適切性之舒適護理,妥善緩解手術後傷口之疼痛不適;運用同理心、關懷傾聽及陪伴個案,減輕憂鬱心情並滿足睡眠的生理需求;在照顧者緊張的部分,則以提升各項照顧技能、認識疾病照護等,改善緊張問題。加上介入跨團隊照護,使個案在經歷疾病及治療過程中能得到安全與歸屬感,使其調適面對疾病的不確定感。
This article describes the nursing experience of working with a 53-year-old woman patient who suffered from ascite with ovarian cancer. She faced acute pain caused by post-operative wounds, as well as negative emotional response to uncertainty about the disease and surgical prognosis, and the caregiver's unfamiliarity with the content of the care causes the caregiver's stress. The nursing period was from March 22 to April 7, 2017. The Gordon's 11 functional health assessment tool was used. Data were collected through observations, interviews, listening, hysical assessment, and medical records. During the period of care, provide individual and appropriate comfort care to relieve post-operative pain. Using empathy, caring, listening and accompanying with patient to alleviate emotional distress and the physiological needs of sleep. In caregiver Roles Strain, reduce stress problems by improving care skills and understanding of disease care, etc. And multidisciplinary intervention let patient feel safe and sense of belonging in treatment, as well as that patient can adapt to face the uncertainty of the disease.