一位膀胱癌病患接受迴腸膀胱造口手術之護理經驗

The Nursing Experience of A Post-operative Bladder Cancer Patient with Ileal Conduit

黃淑燕(Shu-Yen Huang) ； 魏惟琪(Wei-Chi Wei) ； 李美慧(Mei-Hui Lee) ； 潘淑卿(Sh-Ching Pan)

《高雄護理雜誌》 28卷2期 (2011/08) Pp. 57-66

https://doi.org/10.6692/KJN-2011-28-2-6

摘要

本文探討67歲女性病患，因先後罹患鼻咽癌、膀胱癌兩種癌症，且因膀胱癌需接受膀胱全切除及迴腸膀胱造口手術時，面臨的衝擊與調適過程之護理經驗。筆者於2008年6月23日至7月9日期間，運用Gordon十一項功能性健康型態評估工具，經由觀察、會談等方式收集並分析資料，依據護理診斷，確立其護理問題有：急性疼痛、營養狀況少於身體所需、自我照顧能力缺失／迴腸膀胱造口留置有關、潛在危險性感染、身體心像改變、恐懼。照護期間與病患建立良好的人際關係，使病患能正向面對疾病造成的身體心像、排尿系統的改變及害怕死亡所產生的恐懼，適時提供相關資訊及情緒支持，進而提升使病患具更正向的疾病適應。

關鍵字

膀胱癌 ； 迴腸膀胱造口

並列摘要

This study intends to explore the post-operative nursing experience of a 67-year-old female patient suffering from nasopharyngeal cancer and bladder cancer. After total cystectomy and ileal conduit surgery, the patient experienced a giant impact on her body image and mental condition, and needed to adjust to this. During the period of June 23 to July 9 2008, according to the Gordon 11 item Functional Assessment of Health, the author collected data and analyzed information through observing and interviewing, and then the nursing diagnosis can be classified as: acute pain, imbalanced nutrition less than body requirement, self-care deficit, risk for infection, disturbed body image, and fear. The nurse played an important role in building a good relationship with the patient during the nursing period in order to allow the patient be more positive in accepting her altered body image and altered urinary elimination system and overcome the fear of death. In addition, providing the patient with relevant information and mental support to facilitate better adaptation was also a focus.

並列關鍵字

bladder cancer ； ileal conduit