- 期刊
照護初診斷乳癌行全乳根除併立即性自體組織重建病人之護理經驗
The Nursing Experience for a Newly Diagnosed Breast Cancer Patient who had Received Modified Radical Mastectomy and Immediate Autonomous Tissue Reconstruction
摘要
本文描述一位44歲初診斷乳癌患者，於尚未接受罹癌事實，卻迫接受左側全乳根除併立即性自體組織重建術之護理經驗。筆者於2011年11月19日至11月26日護理期間運用羅氏適應理論為評估工具，以實際護理、觀察、會談、身體評估及病歷查閱等方式收集資料，經分析後確立個案健康問題為焦慮、潛在危險性感染、知識缺失及無效性個人因應能力等，照護過程運用關懷、同理心等技巧與個案建立互信關係，扮演傾聽、支持及諮詢者的角色，引導個案訴說擔心害怕的事，協助度過首次罹癌及手術過程的不安及不確定感；應用乳癌照護手冊，衛教個案及家屬傷口、管路照護及手臂復健運動等相關知識，協助個案自我照護，以預防傷口感染、減輕對術後手臂復健運動不了解之壓力；鼓勵表達疾病所衍生的感受及重新釐清個案對癌症認知，協助建立因應技巧，使個案、家屬能有勇氣、信心正向面對後續癌症醫療處置，藉此提供此護理經驗做為日後照顧此類個案之參考。
並列摘要
This paper aimed to present the nursing experience of a 44-year-old female patient who received modified radical mastectomy and immediate autologous tissue reconstruction. During the nursing period, from November 19th to 26th in 2011, the nursing assessment was developed within the framework of Roy adaption model. Data were collected by observation, interview, physical assessment and chart review. Patients' health problems were anxiety, potential hazardous infection, deficient knowledge and ineffective coping ability. Mutual trust relationship was developed during nursing care period using fear. listening, supporting and consulting. Patients were led to tell the feelings of worry and They were helped to overcome the worries and uncertainties during the operation process of newly diagnosed cancer. Breast cancer care manual was used to provide post-operative nursing instruction. Patients and families were taught how to care the wound and drainage tubes. Arm rehabilitation exercise and the ability of facing pressure were also introduced. Expressing the inner feeling was encouraged. Re-clarifying the cognition of breast cancer made the patient and family brave and confident. They can face the subsequent treatment with positive attitude. This nursing experience may be a reference for caring these groups of patient.