- 期刊
照護一位大腸癌導致腸皮瘻管個案之護理經驗
Nursing a patient of colorectal cancer leading to intestinal fistula
摘要
本文旨在照顧一位大腸癌個案因術後發生左腹部蕈狀傷口潰瘍及腸皮膚瘻管合併症，而行腹壁腫瘤切除術及胃空腸吻合術之護理經驗，護理期間為2013/12/20～2014/01/20，經由Gordon 十一項評估進行資料收集，並於觀察、會談後，確立個案護理問題有疼痛，組織完整性受損、焦慮、營養少於身體所需等。照護過程中，視個案之傷口情況給予個別性照護，監測體液輸入與輸出量，提供足夠的營養，靈活運用適合個案的傷口護理方式，避免周圍皮膚浸潤潰瘍惡化；並提供正確的醫療照護訊息，再三的指導自我照顧之要領，使其能儘早回歸家庭與社會。個案面對疾病的病痛與死亡威脅，產生焦慮情緒的反應，此時除了減輕個案疼痛、提供急性期照護之外，適時主動關懷，運用同理心，接受個案的情緒及感受，舒緩了個案焦慮的情緒，獲得休息睡眠。希望藉此護理經驗能提供護理人員之參考，讓類似個案能獲得個別性、整體性的醫療照護，提升護理品質。
並列摘要
The subject was a colorectal cancer patient who faced the complications of mushroom-shaped ulcer wounds at left abdomen and intestinal fistula after surgery. The purpose of this article was to share the experience of nursing the patient who received an abdominal tumor resection and a gastrojejunostomy afterwards. The nursing period was between December 20, 2013 and January 20, 2014. The data was collected by using Gordon's 11 functional health patterns assessment, observations, and interviews. The results showed that the patient encountered problems of pain, impaired tissue integrity, anxiety, and not enough nutrition. In the nursing period, patient individuality and unique needs based on the wound conditions were embraced. The input and output of body fluids were monitored. Enough nutrition was provided to the patient. Appropriate wound care methods were provided to avoid infiltration and ulceration of the skin. In addition, the patient was provided with correct health care information and self-care essentials to be helped return to normal life. Regarding the anxiety caused by ill pain and death threat, pain relief and acute care were provided. Active care, empathy, and accepting the patient's emotions and feelings were provided as well, which relieved the patient's anxiety and helped the patient gain more rest and sleep. Medical professionals could use this nursing experience as reference to provide patients with similar conditions individuality and holistic medical care.
延伸閱讀
- 林秀秀、郭憲華（2014）。照護一位大腸直腸癌併惡性腸阻塞護理人員之護理經驗。醫學與健康期刊，3(2)，131-142。https://www.airitilibrary.com/Article/Detail?DocID=23046856-201409-201409250083-201409250083-131-142
- 馮湘婷、李佳倫（2015）。一位初診斷直腸癌行腸造口術病人之護理經驗。安泰醫護雜誌，21(1)，1-11。https://www.airitilibrary.com/Article/Detail?DocID=18111955-201506-201508110005-201508110005-1-11
- 莊玟玲、謝岫庭（2009）。一位惡性蕈狀傷口合併腸皮瘻管個案之護理經驗。護理雜誌，56(1)，91-95。https://doi.org/10.6224/JN.56.1.91
- 張蓉馨、陳雅紅、周佳諦、李淑儀（2022）。照護一位大腸癌病人術後併行永久性腸造瘻口的護理經驗。源遠護理，16()，13-20。https://doi.org/10.6530/YYN.202209_16(S).0002
- 王翠蘭（2008）。Nursing a Terminal Patient with Combined Tongue and Colon Cancer。志為護理-慈濟護理雜誌，7(1)，126-135。https://doi.org/10.6974/TCNJ.200802.0126