照顧一位初次罹患口腔癌患者術後之加護經驗

A Critical Care Nursing Experience for a Patient with Oral Cancer Postoperative

段順慧(Shun-Huei Duan) ； 邱亭軒(Ting- Hsuan Chiou)

《馬偕護理雜誌》 14卷2期 (2020/07) Pp. 57-68

https://doi.org/10.29415/JMKN.202007_14(2).0006

摘要

本文為描述一位50歲男性，因診斷口腔癌入院接受手術治療，並於術後入住加護病房之護理經驗，護理期間自2017/09/13至2017/09/20，筆者運用觀察法、身體評估、會談及翻閱病歷等方式收集資料，並以Gordon十一項健康功能型態為評估架構確立個案護理問題有急性疼痛、皮膚完整性受損、焦慮等。在護理過程中，提供適切且具個別性的照護計畫，過程中密切觀察移植皮瓣之變化，並維持其功能，針對手術後留置氣切造口，導致無法順利表達，進而產生的焦慮情形，筆者藉由耐心陪伴、主動關懷，建立良好的治療性人際關係外，藉由團隊照護方式提供疾病相關衛教，增進個案對未來照護的認知，使其重獲身體的控制權，拾起信心並鼓起勇氣面對後續照護活動，促使個案早日回歸正常。

關鍵字

口腔癌 ； 急性疼痛 ； 皮膚完整性受損 ； 加護護理 ； 護理經驗

並列摘要

This paper described a post-operative ICU nursing experience of a 55 years old male patient receiving free flap reconstruction due to oral cancer. The nursing period lasted from September 13th to 20th, 2017. Data were collected via Gordon's functional health pattern assessment, the author collected data through observation, conversation, physical assessment, and medical chart review. Following health issues were identified: acute pain, impaired skin integrity and anxiety. During the nursing process, the author provided the appropriate and personal caring plan to reduce the pain; observed flap blood flow to maintain the function. The tracheostomy patient unable to express adequately resulted in anxiety, the author provide a continuous care. The nurses engaged in active care for the patient and family by listening to the patient's emotional experience during body image alteration, and finally assisted the patient in accepting the alteration of body image. The author taught him about necessary instructions to help him to accept the disease, adapt himself to the future and obtain satisfaction with his body and mind.

並列關鍵字

oral cancer ； pain ； impaired skin integrity ； critical care ； nursing experience