一位罹患食道癌執行食道重建手術病人的護理經驗

Nursing Experience of Caring a Esophageal Cancer Patient undergoing Esophageal Reconstructive Surgery

蘇鈺婷(Yu-Ting Su) ； 楊宜霖(Yi-Ling Yang) ； 楊淑貞(Shu-Chen Yang)

《馬偕護理雜誌》 14卷1期 (2020/01) Pp. 14-24

https://doi.org/10.29415/JMKN.202001_14(1).0002

摘要

本文為描述照護一名66歲男性，因罹患食道癌入院執行食道癌重建手術的護理過程，個案因治療的歷程時間較長，產生生理、心理、社會及經濟來源不足等問題，藉由醫療團隊的照護，護理人員居中協調、溝通來協助因應。護理期間為2017年5月17日至2017年6月13日，筆者藉由Gordon十一項功能性健康型態為基礎架構來評估個案，藉由觀察、會談、傾聽以及身體評估來蒐集資料，確立個案健康問題有：1.疼痛／與手術後傷口及管路留置有關、2.傷口潛在性感染／與手術後傷口及管路留置有關、3.焦慮／與擔心疾病預後、經濟來源缺乏、對疾病的理解力差有關。在照護過程中，除了滿足個案生理上的需求，同時與其建立良好的護病關係，藉由傾聽與陪伴讓個案卸下心防主動說出自己的經濟壓力及心裡的不安，並溝通、協調、提供跨團隊的照護與補助，讓個案能夠安心的接受治療以及能夠正向的面對未來的社會生活回歸。期許藉由此照護經驗，讓未來臨床上更多護理同仁能夠更正視病人的每一個需求，運用團隊合作的方式進而達到全方位的照護。

關鍵字

食道癌 ； 護理 ； 食道重建手術 ； 生活品質 ； 團隊合作

並列摘要

The article presents a case study of the nursing care of a 66-year-old male who was hospitalized for esophageal cancer reconstructive surgery because of esophageal cancer. In the course of the care, the patient experienced a long entire treatment, resulting in physical, psychological, social and economic insufficiency. With the care of the teamwork, the nursing staff coordinated and communicated with each other to assist in the response. The nursing period of During May 17, 2017 to June 13,2017, the author used Gordon's eleven functional health patterns as an infrastructure to collect information through observations, communication skills, listening and physical assessments. Confirmed the case health issues include: 1.Pain/related to postoperative wound and tube retention, 2.Potential wound infection/related to postoperative wound and tube placement, 3.Anxiety/concern about the prognosis of the disease, lack of economic sources, and poor understanding of disease. In the process of care, in addition to satisfying his physiological needs, author also established a good relationship with the patient by listening and accompany the patient to open his heart and actively spoke out his own economic difficulties and psychological uneasiness. By actively assisting and providing cross-team care and assistance, the patients can be treated peacefully and can face a positive return of social life in the future. Hoping by this experience of care, more clinical nurses will be able to face up to each possible patient's needs and use a team approach to achieve a full range of nursing care in the future.

並列關鍵字

Esophageal cancer ； Nursing care ； Esophageal cancer reconstructive surgery ； Quality of life ； teamwork