一位口腔癌末期合併惡性腫瘤傷口病患之護理經驗

The Nursing Experience of a Terminally Ill Oral Cancer Patient with Malignant Wound

曾雅玲(Ya-Ling Tzeng) ； 凃秀妮(Shiow-Ni Two)

《腫瘤護理雜誌》 9卷1期 (2009/06) Pp. 61-71

https://doi.org/10.6880/TJON.200906_9(1).06

摘要

近年來，口腔癌病患在台灣日益增加，疼痛和難以癒合的腫瘤傷口經常嚴重影響他們的身體與心理安適以及社交關係，因此舒適照顧對病患而言非常重要。本文探討照護一位口腔癌末期病患之護理經驗，照護期間自2006年7月5日至2006年7月19日，以Gordon十一項健康功能評估進行護理評估，確立個案主要護理問題為：疼痛、組織完整性受損、社交隔離、預期性哀傷。護理過程中，因為個案傷口疼痛並持續擴大且散發臭味，筆者以輕柔換藥動作、使用止痛劑、冰敷來減輕傷口造成的疼痛；藉由增加換藥次數與紗布上放置茶包，使傷口惡臭味明顯減輕；除此之外，筆者除了用心傾聽病患，更運用字卡以促進病人與他人的溝通，照護期間貼心照護與情緒支持也幫助作者與病患建立信任關係；此外，筆者亦協助及支持案妻表達哀傷，並得到情緒抒解。期望藉此護理經驗之分享，俾後能協助護理同仁提供口腔癌末期病患及家屬身、心、靈與社會需求的更佳照護。

關鍵字

口腔癌 ； 組織完整性受損 ； 社交隔離

並列摘要

In recent years, the numbers of oral cancer patients are increasing in Taiwan. They often suffer from pain and difficult healing malignant tumor wounds which had severely affected their physical and psychological wellbeing and their social relations. Therefore, tender loving care is very important to these patients. This article is exploring the care of a terminally ill patient's oral cancer nursing experience, care during July 5, 2006-July 19, 2006, which is based on Gordon 11 functional health assessment and nursing assessment to establish the case primary care issues such as: pain, impaired tissue integrity, social isolation and anticipatory grief. During the nursing process, because the cases of wound pain, continuing expansion and foul smell, the author changed the dressing gently and gave analgesics and ice compression whenever needed. Changing dressing frequently and put tea bags on gauze reduced the stench significantly. The author not only listened carefully to the patient's need, but also used the word cards to promote communication between patients and others. During the intimate nursing, tender loving care and moral support had helped establishing a trust relationship between the author and the patient. Furthermore, by assisting and supporting the patient's wife expressed her grief, the author also helped her relieve her emotional concerns. By sharing this nursing experience, the author wishes to help nursing colleagues provide terminally ill oral cancer patients and their families in body, mind, and spirit with social demand for better care.

並列關鍵字

oral cancer ； impaired tissues integrity and social isolation