照護一位罹患卵黃囊腫瘤婦女之護理經驗

Nursing Experience of A Woman Suffering from Yolk Sac Tumor

蔡惠如(Hui-Ju Tsai) ； 鍾芬芳(Fen-Fang Chung) ； 蔡麗紅(Li-Hung Tsai)

《長庚科技學刊》 34期 (2021/06) Pp. 133-144

https://doi.org/10.6192/CGUST.202106_(34).11

摘要

本文旨在描述一位罹患卵黃囊腫瘤之婦女，住院接受減積手術，所造成的生理及心理衝擊之護理經驗。護理期間自2018年10月4日至2018年10月12日。照護期間運用整體性護理評估架構，確立個案有：「焦慮」、「急性疼痛」、「親職角色衝突」之健康問題。透過周全的手術前後照護，與個案建立良好護病關係、引導說出心中的擔憂、並協助其與醫療團隊溝通，以增加個案對疾病治療的控制感進而減輕焦慮；提供疼痛緩解的方法，如轉移注意力、避免傷口牽扯、背部肌肉按摩、評估疼痛之PQRST，並適時給予止痛劑使用；表達同理心並分享同為母親照顧經驗，提供親子依附之方式、鼓勵案夫探視並表達關愛及安排家庭會議以協助個案增加支持系統，進而減輕其親職角色衝突之壓力。盼藉此經驗能提供護理人員作為日後在照顧類似病患之參考。

關鍵字

卵黃囊腫瘤 ； 焦慮 ； 急性疼痛 ； 親職角色衝突

並列摘要

This case report describes the experience of caring for a woman suffering from yolk sac tumor with debulking surgery. Through a comprehensive nursing assessment from October 04 to October 12, 2018, both physical and psychological impacts were revealed as following: anxiety, acute pain, and parental role conflict. A sophisticate pre-post operation nursing care was developed to increase the sense of control of surgery to reduce anxiety. The author built up a trust relationship with the patient, guided her expressing concerns about the surgery, and assisted the patient to communicate with the medical team. PQRST pain assessment, back massage, and attention distracting were utilized for pain relief. Analgesics was used when needed. The author shared mothering experience to express empathy, and arranged mother-infant attachment to reduce the stress of parental role conflict. Patient's husband was encouraged to show love while visit. Happy family meetings were delivered to enhance patient's support systems. The findings may be helpful as a reference in caring for women with similar experience.

並列關鍵字

yolk sac tumor ； anxiety ； acute pain ； parental role conflict

參考文獻

吳淑芬、林佑樺、李來涼、簡婉儀(2014)．婦科癌症患者的疾病不確定感與憂鬱之相關性探討．護理暨健康照護研究，10 (2)，83-93。doi: 10.6225/jnhr.10.2.83

邱意云、吳婷婷、湯詠卉(2015)．照護一位行婦科減癌手術婦女之護理經驗．榮總護理，32 (1)，31-38。doi: 10.6142/vghn.32.1.31

洪郁涵、黃煒淇、陳思穎、蔡麗紅(2017)．照顧一位初診斷女性乳癌的護理經驗．長庚科技學刊(27)，109-119。doi: 10.6192/cgust.201712_(27).12

張書瑜(2015)．一位產後突發顱內出血經產婦之護理經驗．助產雜誌(57)，80-91。doi:10.6518/tjom.2015.57.8

張純純、陳月枝、胡文郁、楊志新(2011)．罹癌母親親子互動之經驗歷程．安寧療護雜誌，16 (3)，326-337。doi: 10.6537/tjhpc.2011.16(3).4