照顧一位因迴腸造口合併症產生無力感患者之經驗

本文探討一位54歲女性，因腸扭結合併腸穿孔行部分大腸切除術及環狀迴腸造口術，出院後因體重急速降低，導致腸造口底座易滲漏，產生造口皮膚嚴重合併症而出現信心喪失、懼食、自殘等行為。於2017年10月07日至2017年12月25日照護期間，藉由觀察、傾聽、會談、身體評估、病歷資料閱覽等方式收集資料，以Gorden 11項健康功能型態評估做為評估工具，發現病人本是一位注重外觀及生活品質之女性，但因一直無法有效改善腸造口皮膚合併症情形而出現無力感、營養失衡：少於身體需要、皮膚完整性受損等健康問題，導致其失去學習意願及外觀枯槁、邋遢，故依病人狀況設計符合其需求之衛教輔助工具及個別性的腸造口照護方法，皮膚護理方式與相關飲食衛教，使病人於護理期間學會照護技巧並重拾信心，回歸正常生活。

關鍵字

環狀迴腸造口；腸造口併發症；無力感

並列摘要

The patient is a 54-year-old woman. Due to undertaken a surgery of partial colectomy removal and loop ileostomy, body weight drop rapidly, the stoma base is easy to leak and combine with no proper skin care, which resulting in a serious complication of stoma skin. This situation made her lost confidence, appetite, and began to self-mutilation. Data were collected through observation, listening, interviews, physical assessment, medical record reading, etc. with Gordon's 11 Functional Health Patterns as assessment tools during the nursing period of care from October 07, 2017 to December 25, 2017. Found that the patient who pays attention to the appearance and quality of life, but because of inability to improve ostomy skin complication effectively, imbalance of nutrition and other health problems, which resulting in it loses its willingness to learn and whose appearance is dry and awkward. Therefore, according to the patient's condition, the teaching aids of preventing the leakage of stoma base, well of skin care, and diet education are designed for her and we encouraged her participating in her own stoma care process and made her regained confidence.

並列關鍵字

Ileostoma ； Stoma and peristomal complications ； Powerlessness

國際替代計量

照顧一位因迴腸造口合併症產生無力感患者之經驗

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