照護一位初次診斷乳癌婦女術後之護理經驗

Nursing Experience on a Post-operative Women When First Diagnosed with Breast Cancer

陳雅琪(Ya-Chi Chen) ； 邱婉婷(Wang-Ting Chiu)

《馬偕護理雜誌》 15卷2期 (2021/07) Pp. 69-79

https://doi.org/10.29415/JMKN.202107_15(2).0007

摘要

本文描述一位初次罹患乳癌婦女術後之護理經驗。護理期間由2018年2月26日至2018年3月9日，以Gordon十一項健康功能評估作為架構，於護理過程中運用觀察、會談、身體評估、病歷查閱等方式收集資料，確立護理問題有急性疼痛、焦慮、身體心像改變等健康問題。筆者於照護過程中運用藥物與非藥物的方式，減緩手術後傷口急性疼痛；以同理心及主動關懷病人，建立良好治療性信任關係，藉由支持、傾聽，進而指導居家手臂復健運動、適切提供疾病照顧相關資訊等，提升其因應疾病壓力能力；鼓勵病人說出疾病所造成的影響並表達內心感受，協助緩解其不安情緒，引導適應外觀與生活上的改變，了解身體心像改變問題，協助肯定自我價值，進而提供整體性、個別性的護理措施，讓病人能重新適應生活軌道。

關鍵字

乳癌 ； 身體心像改變 ； 手臂復健運動 ； 壓力因應失調

並列摘要

This article described postoperative care experience of a woman who was first diagnosed with breast cancer. The nursing period was from February 26, 2018 to March 9, 2018 and data were collected through direct nursing care, interviews, physical examinations and assessments, and retrospective investigation on medical records. Using Gordon's eleven functional health history assessments, major health problems were identified, such as acute pain, personal stress disorder, and changes in mental and body image. Both Pharmacological- and non-pharmacological therapeutic approaches were used to alleviate the patient's acute pain related to the surgical wound. With empathy and a good trust relationship, the patient was provided information to perform arm rehabilitation exercises later at home and relevant information about the disease and care in order to improve her ability to cope with the stress. In addition, care providers have encouraged the female patient to speak about the impact of the disease, express her inner feelings to ease uneasiness, adapt to changes in appearance and life, adjust to changes in physical and mental image, and assist in affirming self-value so as to provide holistic and individual nursing care.

並列關鍵字

first-diagnosed breast cancer ； postoperative care ； changes in body and mental image ； rehabilitation exercise ； stress

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