一位未婚女性罹患卵巢癌之照護經驗

Nursing Experience Caring for a Unmarried Women With Ovarian Cancer

楊雪婷(Huseh-Ting Yang) ； 謝馥矯(Fu-Chiao Hsieh) ； 魏雅雯(Ya-Wen Wei) ； 王乙茜(Yi-Chian Wang)

《領導護理》 22卷2期 (2021/06) Pp. 80-95

https://doi.org/10.29494/LN.202106_22(2).0006

摘要

本文描述一位39歲未婚女性罹患卵巢癌，行子宮、雙側卵巢輸卵管全切除之照護經驗，因個案面對病情不可預期之結果產生焦慮及不確定感、術後面臨傷口疼痛、無法生育及化療後預期掉髮等之身體心紊亂而引發負面情緒，故引發筆者動機，照護期間自2017年8月10日至2017年8月21日，運用Gordon十一項健康功能性型態進行整體性評估，藉由直接護理、傾聽、觀察、會談及查閱病歷等方式收集資料，經評估後發現個案有1.焦慮／與對病情不可預期與對後續化學治療不了解有關，2.急性疼痛／與術後傷口有關，3.身體心象紊亂／與卵巢子宮全切除後無法生育與擔憂化療落髮有關等健康問題。於術前採取主動關懷，建立良好護病關係，提供個別性護理衛教指導以減輕焦慮，術後透過直接身體照護及醫療諮詢，提供個案減輕疼痛，並協助個案接受子宮卵巢全切除後造成無法生育，所帶來的壓力與衝擊，提供個案足夠的知識及跨團隊全人照護，儘早恢復健康及步入生活軌道，維持其良好的生活品質。期望藉由照護類似個案之經驗，與相同領域的護理同仁分享，能提供護理人員日後照護之參考。

關鍵字

卵巢癌 ； 疼痛 ； 身體心像紊亂

並列摘要

This article describes the nursing experience of a 39-year-old unmarried woman suffering ovarian cancer who underwent abdominal total hysterectomy and bilateral salpingo-oophorectomy. The patient developed negative emotions caused by physical and mental disorders such as anxiety and uncertainty from unpredictable prognosis of the disease, wound pain after surgery, infertility and anticipating hair loss after chemotherapy. So it triggered the author's motivation, and the nursing period was from August 10th to August 21th, 2017. Employ Gordon Eleven Functional Health assessments as framework, data were collected via direct care, listening, observation, interviews, and researching medical records. The issues identified include anxiety to uncertainty, postoperative pain, and infertility after surgery as well as hair loss after chemotherapy. In response to those problems, the authors provided proactive care before the operation and established a good relationship with the patient to relieve anxiety. Medical consultation suggested multimodal analgesia to reduce postoperative pain, and the team helped the patient to tolerate inability to deliver childbirth. The authors provided sufficient knowledge and multi-disciplinary care to the patient to overcome the stress and impact caused by the disease, in order to help patient restore health as soon as possible and maintain good quality of life style. It is hoped that the experience of nursing care will provide nursing staff as a caring reference for similar patient in the future.

並列關鍵字

ovarian cancer ； pain ； body image disturbance

參考文獻

吳盈慧、許碧鳳、古雪貞（2017）‧運用不確定感理論照顧一位卵巢癌之護理經驗‧馬偕護理雜誌，11(1)，80-91。https://doi.org/10.29415/JMKN.201701_11(1).0007

李逸剛、李耀泰、陳福民、郭宗正（2018）‧正子攝影或正子合併電腦斷層攝影在卵巢癌的追蹤檢視‧台灣醫學，22(6)，657-661。https://doi.org/10.6320/FJM.201811_22(6).0012

洪姿婷、郭惠貞（2019）‧運用輔助療法照顧一位卵巢癌復發患者之護理經驗‧領導護理，20(3)，79-90。https://doi.org/10.29494/LN.201909_20(3).0007

郭貞嬋、李霈宸、邱存梅、賀倫惠（2019）‧降低骨科病人手術後疼痛程度‧長庚護理，30(1)，346-360。https://doi.org/10.6386/CGN.201909_30(3).0006

陳威宏（2019）‧ERAS 術後多模式疼痛治療‧台灣醫學，23(2)，212-222。https://doi.org/10.6320/FJM.201903_23(2).0009