- 期刊
照護一位腹腔鏡直腸癌切除併行迴腸造口個案手術全期之護理經驗
Perioperative Nursing Experience from Caring a Patient Who Receives Laparoscopic Rectal Cancer Resection and Ileostomy
摘要
本文敘述一位49歲女性因罹患直腸癌而接受腹腔鏡直腸癌切除及迴腸造口術之手術全期護理經驗。手術護理期間為2016年7月24日至7月28日，術後繼續追蹤探訪至7月28日出院以評估連續性照護成效。於手術前運用會談、觀察、身體評估及查閱病歷方式收集資料，以Gordon十一項功能性健康型態評估為基礎，評估個案之生理、心理、社會、靈性及發展等整體層面之健康問題，確認個案主要的護理問題包含焦慮、潛在危險性傷害及急性疼痛。筆者於手術前經由術前訪視，以傾聽、主動關懷及鼓勵個案，並提供個別性之手術前與手術後相關衛教，緩解個案面對手術之焦慮情緒，於手術中期依照手術室標準流程提供安全的防護措施預防潛在危險性傷害，手術後依據臨床實證提供系統性的疼痛評估與護理，確實降低個案急性疼痛的問題，藉此護理經驗提供手術前、中、後完整之護理，以維護個案生理與心理全方面之照護。
並列摘要
This article describes the perioperative nursing experience from caring a 49-yearold patient who had received laparoscopic rectal cancer resection and ileostomy. The nursing period is from 24th to 28th of July 2016 and the post-op follow up continues until 28th of July in order to evaluate the ongoing care effectiveness. Preoperatively, the data collection method is conducted by interview, direct observation, physical assessment and retrospective chart review. The patient's physical, psychological, social, spiritual and development in regards to health issues are evaluated based on Gordon's 11 Function Health Patterns. The major nursing problems identified include anxiety, potential hazard and acute pain. Preoperatively, we attempt to relief anxiety by pre-op visit, from listening, active caring and hence motivating the patient. Furthermore, individualized pre-op and post-op patient instructions were provided. Intraoperatively, the preventive safety complying standardized operative procedure was conducted in order to prevent the risk of injury. Postoperatively, we provide systemic pain evaluation and nursing care in accordance with evidence-based method to ensure the alleviation of patient's acute pain. From the experience of pre-op, intra-op and post-op nursing care, we are able to provide the patient with comprehensive psychological and physical care.