協助結直腸癌病人接受雙側腸造口之護理經驗

本文描述一位結腸直腸癌病人接受雙側腸造口術後，因非預期造口留置，對排便通道改變引發身心調適問題的護理經驗。照護期間自2018年4月5日至4月18日，運用Gordon十一項功能性健康型態評估，以直接照護、觀察、身體評估與會談方式收集資料，確立有「無望感」、「身體心像紊亂」、「自我照顧能力缺失」護理問題。護理過程中建立良好護病關係，扮演傾聽、支持及諮詢角色，陪伴病人說出內心感受，減輕對惡性腫瘤不確定感引發之無望感；依病人特性修正教學方式，教導造口照護技巧，成功協助病人完成造口更換，肯定自我能力；鼓勵正視及接納身體外觀改變並學會居家照護，期望藉此經驗提供臨床護理人員參考，協助類似病人出院後恢復日常生活，維持生活品質。

關鍵字

結直腸癌；腸造口；自我照護

並列摘要

This article describes the nursing experience of a patient with colorectal cancer who underwent a bilateral intestinal stoma after an unintended indwelling stoma. The change of defecation passage caused the problem of physical and mental adjustment. During the care period from April 5 to April 18, 2018, Gordon's eleven functional health assessments were used to collect data through direct care, observation, physical assessment, and interviews to establish a sense of hopelessness and physical ＂Mental image disorder＂ and ＂lack of self-care ability＂ nursing problems. Establish a good nurse-patient relationship during the nursing process, play the role of listening, supporting and consulting, accompany the patient to express their inner feelings, and reduce the sense of hopelessness caused by the uncertainty about the malignant tumor; Modify the teaching method according to the patient's characteristics, teach the stoma care skills, successfully assist the patient to complete the stoma replacement, and affirm the self-ability; Encourage to face up to and accept changes in body appearance and learn to take care of home. It is hoped that this experience will provide clinical nurses with reference to help similar patients return to daily life after discharge from the hospital and maintain their quality of life.

並列關鍵字

Colorectal cancer ； Enterostomy ； Self-care

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