一位年輕乳癌病人行腹直肌皮瓣重建術之護理經驗

本文描述照護一年輕女性罹患乳癌行腹直肌皮瓣重建術後之護理經驗，照護期間為2019年3月25至31日，運用生理、心理、社會及靈性層面評估，確立個案有組織完整性受損、急性疼痛及身體心像改變之健康問題。透過傷口衛教單張，使個案及家屬學習傷口照護，以降低皮瓣傷口感染。給予止痛藥物及分散注意力、避免碰撞傷口以減輕不適感等非藥物處理方式以緩解疼痛。此外，作者運用同理心及傾聽方式給予個案正向鼓勵，以增進其自信心。最終讓個案能正視其傷口，降低身體心像的負向感受，並重返規律生活。期盼本照護經驗可做為日後照顧年輕乳癌女性之參考。

關鍵字

乳癌；腹直肌皮瓣；年輕女性

並列摘要

This article describes the nursing experience for a young patient of childbearing age who underwent transverse rectus abdominis myocutaneous flap reconstruction surgery. Between March 25th to 31st, 2019, biopsychosocial and spiritual assessments were conducted to determine health issues including impairment of tissue integrity, acute pain and disruption of body image. Through wound care pamphlets, the patient and family could learn proper wound care so as to reduce the risk of wound infection. To achieve pain relief, medical interventions such as prescription of analgesics and non-medical interventions including education on attention diversion and avoidance of wound contact were provided. Additionally, patient confidence was inspired through encouragement based on proactive empathy and attentive listening. Ultimately, the patient was able to fully face and accept her wound by diminishing negative feelings towards her own body image thereby returning to a normal life. The nursing experience in this article should serve as a reference of care for such patients with breast cancer.

並列關鍵字

Breast cancer ； transverse rectus abdominis flap ； young woman

參考文獻

李家瑩、陳美伶(2016)．乳癌婦女化療引起閉經之現象及其更年期症狀表現．護理雜誌，63(5)，19-26。

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陳紀伃、黃惠滿、林婉如、陳咨淇(2020)．乳癌術後婦女之身體心像與憂鬱傾向之探討．高雄護理雜誌，37(1)，1-12。https://doi.org/10.6692/KJN.202004_37(1).0001

趙玉環、李姿儀、許樹珍(2018)．從多重理論模式綜觀乳癌倖存者過渡期照護之影響因素與介入策略．護理雜誌，65(1)，83-89。https://doi.org/10.6224/JN.201802_65(1).11

Astanehe, A., Temple-Oberle, C., Nielsen, M., de Haas, W., Lindsay, R., Matthews, J., McKenzie, D. C., Yeung, J., & Schrag, C. (2018). An enhanced recovery after surgery pathway for microvascular breast reconstruction is safe and effective. Plastic and Reconstructive Surgery Global Open, 6(1), el634. https://doi.org/10.1097/GOX.0000000000001634

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一位年輕乳癌病人行腹直肌皮瓣重建術之護理經驗

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