照顧一位罹患食道癌病人接受食道重建手術之護理經驗

本文為照顧一位50歲男性因罹患食道癌行食道重建手術之護理經驗。護理期間自2017年6月4日至2017年6月20日，筆者以羅氏適應護理模式，以生理功能、自我概念、角色功能及相互依賴四個層面進行評估，並藉由觀察、會談與查閱病歷資料等方式收集資料，確立護理問題有：營養少於身體所需／與食道癌術後禁食及以空腸造瘻管灌食有關；急性疼痛／與食道癌術後傷口及引流管留置有關；身體心像紊亂／與食道癌術後傷口及引流管留置有關。護理過程中，運用醫療團隊照護和營養師共同討論改善個案的營養問題，學習飲食攝取的原則，及積極改善個案術後疼痛狀況，並藉由主動陪伴、傾聽，鼓勵個案表達內心感受，提供疾病的治療及相關知識，協助個案面對術後身體心像改變，重拾信心，使其能調適疾病帶來的衝擊及改變，進而提升生活品質，建議出院前擬定返家後照護計畫並提供相關照護資源，也盼藉此護理經驗提供臨床護理人員日後照護之參考。

關鍵字

食道癌；羅氏適應模式；護理經驗

並列摘要

This article shares the nursing experience for a postoperative esophageal cancer patient. He was hospitalized between June 4, 2017 and June 20, 2017. Using the four concepts of Roy's Theory, including the physical function, self-perception, self-role function, and interdependence, the author evaluated the data collected through observation, conversation, and medical record review. The major health problems of the patient were: 1. insufficient nutrition associated with fasting after postoperative and jejunostomy feeding, 2. acute pain associated with postoperative wounds and drainage tubes placement, and 3. body image disturbance related to postoperative wounds and drainage tubes placement. During the nursing process, the medical team and nutritionist discussed the improvement plan for the nutrition, teaching the principles of diet, and alleviating the acute postoperative pain. Through companionship and listening, the author encouraged the patient to share his feelings. We provided the knowledge of disease treatment, helped him to face postoperative body image disturbance and regain confidence in order to improve the quality of life, and adapt to the impact and changes brought on by the disease. With our experiences, we recommend the evaluation of discharge planning and provision of relevant care resources. We hope this study could be a reference to our fellow nursing staffs for similar situations in the future.

並列關鍵字

esophageal cancer ； Roy's theory ； nursing experience

參考文獻

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照顧一位罹患食道癌病人接受食道重建手術之護理經驗

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