一位接受多次手術後口腔癌患者之護理經驗

Nursing Experience of Caring a Patient with Oral Cancer Underwent Multiple Surgeries

許家華(Chia-Hua Hsu) ； 紀慧真(Hui-Chen Chi) ； 蔡明修(Ming-Hsiu Tsai) ； 李彩緣(Chai-Yuan Lee)

《若瑟醫護雜誌》 6卷1期 (2012/08) Pp. 130-140

https://doi.org/10.30145/STJHMNJ.201208.0012

摘要

本文探討一位口腔癌患者因經歷多次手術及傷口癒合遲緩導致臉部外觀產生明顯改變，造成個案身心靈衝擊之護理經驗。個案術後因臉部外觀改變且腫瘤傷口滲液惡臭，導致個案在意他人眼光、自我封閉，對於生活品質及人際關係，無非是一大衝擊。筆者於2009年9月15至9月29日藉由身體評估、觀察、面談及電訪等方式，以Gordon十一項功能性健康型態評估，確立個案有疼痛及身體心像紊亂護理問題。於護理過程中，藉由傷口評估提供個案完整傷口照護與舒適護理技巧，減少傷口滲液及惡臭，進而減輕對傷口所產生的羞愧感，並藉由關懷、傾聽、同理、陪伴及適時運用藥物及個別性護理措施緩解疼痛、促進個案舒適，提升自我期望，讓個案能正向面對術後身體心像改變路程，重拾人生希望。

關鍵字

口腔癌 ； 疼痛 ； 身體心像改變

並列摘要

This study reported the nursing experience for caring a patient with oral cancer who had undergone multiple surgeries and suffered from delayed wound healing, psychological and spiritual stress caused by significant changes in his facial appearance. During the nursing period between 15th September and 29th September, 2009, Due to postoperative changes in facial appearance and malodorous wounds and exudates, the patient was sensitive to the perspectives of others and was self-enclosed. As a consequence, the quality of life and the interpersonal relationships were heavily affected. By physical assessment, observation, face-to-face interviews and telephone interviews, the author applied Gordon's 11 Functional Health Patterns Assessment to identify the nursing-related problems including pain and body image disturbance. Comprehensive wound care and comfortable nursing were provided to mitigate wound exudates and foul odor accordingly, which subsequently relieved patient's embarrassment. In addition, pain relief and patient comfort were achieved by caring, listening, empathizing, accompanying, proper medication as well as individualized nursing. Patient's confidence was then promoted. The patient accepted the post-operative alteration in body image with positive attitude and the expectations of life were restored as the results.

並列關鍵字

Oral cancer ； pain ； body image disturbance