一位復發性乳癌病人接受乳房重建手術之照護經驗

Experience of Caring for a Patient with Recurrent Breast Cancer Receiving Breast Reconstruction Surgery

施佳瑢(Chia-Jung Shih) ； 潘慧娟(Hui-Chuan Pan) ； 陳繪竹(Hui-Zhu Chen)

《高雄護理雜誌》 33卷3期 (2016/12) Pp. 38-49

https://doi.org/10.6692/KJN-2016-33-3-5

摘要

本文描述一位復發性乳癌婦女行乳房重建手術的護理經驗，筆者照護期間為2013年12月11日至12月18日，藉由直接照護、觀察、傾聽及會談等方式，運用生理、心理、社會、靈性等層面進行整體性評估，確立主要健康問題有焦慮、身體心像紊亂、潛在危險性感染及知識增進的準備等。以關懷、傾聽方式，引導個案表達對於乳癌復發與重建手術的焦慮及感受，提供心理支持，使個案恢復正向身體心像，並邀請案夫一同學習返家後傷口及管路照護技巧。於照護過程中，發現個案因乳癌復發導致對未來不確定感，協同社工師討論並提供支持團體、增加疾病認知及提升自我照護技巧，協助儘早重返家庭與社會生活，落實以病患為中心之個別性護理。希望藉此個案經驗，提供相關疾病照護之參考。

關鍵字

復發性乳癌 ； 乳房重建手術

並列摘要

We describe a nursing experience about a female with recurrent breast cancer receiving breast reconstruction surgery from December 11, 2013 to December 18, 2013. By directly caring, observing, listening to and communicating with the patient, we confirmed the major health problems of anxiety, body image disorder, potentially dangerous infections, and preparation of knowledge promotion through the overall assessments including physical, psychological, social and spiritual aspects. To restore the patient’s positive body image, we also invited her husband to learn the care techniques about the wound and associated tubes after returning home aside from counseling the patient about the methods of caring and listening to express her anxiety and feelings due to breast cancer recurrence and reconstruction surgery. In the care process, we found the patient expressed uncertainty about the future arising from her breast cancer recurrence. As a result, we collaborated with the social worker to provide the patient with supportive groups, to increase her disease awareness and to enhance her self-care skills, helping her to return to the family and social life as soon as possible for the purpose of the implementation of patient-centered individual nursing. We provide this nursing experience in the hope it could be a useful reference in related disease care.

並列關鍵字

Recurrent Breast Cancer ； Breast Reconstruction Surgery