照護一位直腸癌病患接受永久性腸造口之護理經驗

Nursing Experience of a Patient with Rectal Cancer Received Permanent Colostomy

張淑芳(Shu-Fang Chang) ； 許紫燕(Tzu-Yen Hsu)

《安泰醫護雜誌》 17卷3期 (2011/09) Pp. 65-78

https://doi.org/10.7078/TSMHMNJN.201109.0067

摘要

本文為照護一位75歲個案在初診斷為直腸癌時，因害怕面對手術及腸造口留置，先選擇了逃避，之後因腫瘤轉移而入院接受直腸腫瘤切除併永久性腸造口及膀胱腫瘤切除手術後的護理經驗；筆者於2010年3月11日至3月25日照護期間，運用Gordon十一項功能健康型態評估，藉由照護、觀察、會談、身體評估等方式進行資料收集，歸納出個案有急性疼痛、營養狀況改變：少於身體需要、身體心像紊亂、特定性知識缺失等健康問題。在照護過程中筆者透過傾聽、陪伴與個案建立良好的治療性人際關係，提供醫療照護資訊，協助術後疼痛處理，給予飲食指導，教導個案及家屬腸造口照護，使個案能調整心態，重新接受身體外觀改變的事實，進而願意主動參與自我照護，期盼藉此照護經驗之分享，可供護理人員日後照顧此類病患之參考。

關鍵字

直腸癌 ； 腸造口 ； 身體心像紊亂

並列摘要

This study reported the nursing experience for a patient with rectal cancer received permanent colostomy. This patient refused operation and colostomy in the beginning. Due to rectal cancer metastasis, he received intra-abdominal cancer excision, metastatic bladder tumor resection, and permanent colostomy. The duration of nursing care was from March 11th to March 25th, 2010. The Gordon function health assessment guide was used to assess nursing problems through direct care, observation, systematic interview, and physical assessment. The nursing problem of this patient included acute pain, decreased nutrition intake, disturbance of body image, and specifically knowledge impairment. During the nursing care, well relationship between the patient and the nursing staff was built via listening, accompanying and offering medical care information which included pain management, diet and colostomy care. The patient accepted his body appearance and adapted for illness cognition and effective self-care finally. This experience provided a well reference for nursing.

並列關鍵字

rectal cancer ； permanent colostomy ； disturbance body image