直腸癌患者大腸造瘻術後之出院準備服務

Discharge Planning Services in a Colorectal Cancer Patient who Received Colostomy

翁緯玲(Wei-Ling Weng)

《北市醫學雜誌》 5卷6_S期 (2008/12) Pp. 755-760

https://doi.org/10.6200/TCMJ.2008.5.6.19

摘要

本文敘述一位70歲女性罹患大腸癌接受永久性腸造瘻手術後出院準備服務經驗，護理期間運用Orem自我照顧理論為評估架構，確立個案問題有；急性疼痛與組織創傷：手術傷口、床上活動時牽扯傷口有關；身體心像紊亂與永久性腸造瘻導致身體外觀改變有關；特定知識缺失與缺乏人工腸造瘻居家照護知識有關等護理問題。治療過程中引導個案由排斥自己身體心像改變，進而慢慢接受手術後腸造瘻留置。亦讓家屬學會腸造瘻之居家照護，做好家庭角色分配及出院前準備，使病患在充分準備下出院，得到更適切的照護與生活品質。

關鍵字

直腸癌 ； 腸造瘻 ； 出院準備服務 ； 身體心像紊亂

並列摘要

This article describes the experiences involved in the discharge planning of a 70 year old female colorectal cancer patient who had received a permanent enterostomy. During the nursing period, the Orem Self-Care Theory was used as an evaluation framework, and as a result several nursing criteria were established that would help various problems the patient was suffering from. She had, for instance, acute pain from the stretching of her wound while moving in bed, body image disturbance from the change in her physical appearance caused by the permanent enterostomy, and a lack of specific knowledge about her condition made it difficult to prepare for her self-care after release. By developing a good therapeutic relationship with the patient she began to change her attitude toward her body image from initially rejecting to now accepting the fact that she had had an enterostomy. Also, by teaching her family to be a part of her recovery and giving each family member a specific role to play in helping her, and carrying out discharge planning, the patient became more prepared for her discharge from hospital. Consequently she was able to receive a much better and more complete after care service and now has a better quality of life.

並列關鍵字

colorectal cancer ； enterostomy ； discharge planning services ； body image disturbance