一位口腔癌病患於口顎重建術後的加護護理經驗

Nursing Experience of a Post Mandible Reconstruction Patient at ICU

連如玉(Ju-Yu Lien) ； 熊道芬(Tao-Feu Hsiung)

《志為護理-慈濟護理雜誌》 2卷3期 (2003/09) Pp. 77-86

https://doi.org/10.6974/TCNJ.200309.0077

摘要

本報告探討一位口腔癌女性病患，於接受口顎重建術後在加護病房的護理過程。護理過程中筆者經由直接照護、觀察、筆談等方式，用同理心、陪伴和關懷建立了良好的護病關係，並運用“羅氏適應模式”，完整的收集評估資料，確定病患的健康問題為：無法有效維持呼吸道暢通、現存性／高危險性感染、高危險性周邊神經血管功能失常、睡眠型態紊亂、身體心像改變等。針對個案的問題做整體性護理計畫，以護理人員的專業知識和技能，協助病患處理身心健康問題，除提供病患以基本生理需求外，並幫助病患逐漸面對及調適身體心像改變的感受與困擾，使其能勇敢接受日後一連串之贋復重建。謹將此一護理經驗提供大家分享，俾往後對照護此類病患有所助益。

關鍵字

口顎重建 ； 身體心像改變 ； 護病關係

並列摘要

The paper presents the nursing care process of an oral cavity cancer female patient who had mandible reconstruction, physiological and psychological disequilibria after surgery at ICU. By Roy's Adapation Model assessment, the patient's health problems at ICU were identified as follows: ineffective airway clearance, risk for infection, risk for peripheral neurovascular impairment, disturbed sleep pattern and distorted both image. The patient was physically stabilized after the medical and nursing interventions. And through the nursing strategies, the patient's body image changed from apathy, depression, and refused to watch the wound, to demonstrate a willingness to face the further reconstruction process. This successful nursing experience is worth sharing with our nursing stall using the faith of nursing-patient relationship, and nursing professional know ledge and skill. We devoted deeply into the patient’s specifics to do the care plan. Except providing physiological demands, the body image change was also provided, then rejoining the society again. Finally she could face the future optimistically. As a good nursing experience, I hope our colleagnes can benefit from it.

並列關鍵字

mandible reconstruction ； body image disturbance ； nursing-patient relationship