照顧一位乳癌病患手術全期之護理經驗

本文探討一位乳癌婦女因面臨疾病、害怕接受手術的而延遲就醫治療，導致腫瘤侵犯整個乳房並造成出血、傷口異味及外觀改變。筆者於2013年12月20日至2014年1月2日期間運用手術全期護理原則協助個案使其最終手術並積極接受治療。照護初期藉由訪視、觀察、會談及Gordon 11項功能性健康評估，發現個案健康問題有焦慮、潛在危險性傷害、急性疼痛和身體心像紊亂等。確立健康問題後，筆者提供乳房切除及化學治療照護知識，藉由情緒分享、耐心傾聽、轉移注意力等技巧解決其焦慮及疼痛問題；透過直接身體照護及醫療諮詢讓個案接受手術後身體心像，協助個案儘早恢復步入生活軌道。藉此提供手術室人員照護經驗的參考。

關鍵字

乳癌；手術全期；疼痛

並列摘要

This article describes a female breast cancer patient who hesitated to receive therapy resulted in tumor invaded whole breast, as a result of blood loss, wound foul smell and cosmetic change, followed by the patient closed herself eventually. The writer used whole perioperative nursing care guidelines to assist patient to overcome the impact of breast surgery, and to receive aggressive treatment. The period of nursing care was from Dec 20, 2013 to Jan 2, 2014. Clinical interview, observation and discussion were used and guided by Gorden’s health assessment to identify nursing problems. During hospitalization, the major nursing problems were disclosed anxiety, potential risk injury, acute pain and body image disturbance. The author applied appropriate knowledge of mastectomy and chemotherapy with a multiple team approach skill to provide emotional share, patient listening and distraction to relief the patient’s anxiety and pain. Let this case accept post-operative body image disturbance by direct somatic care and medical consultation, and helped this case to recover her normal life way earlier. The author expects that this care experience can be a reference for other nursing care.

並列關鍵字

breast cancer ； perioperative nursing care ； pain

國際替代計量

照顧一位乳癌病患手術全期之護理經驗

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