本報告係探討一位膀胱癌個案在接受膀胱切除後行迴腸導管術所面臨的身、心問題之護理經驗。筆者於民國86 年6月5 日~ 86 年7月7 日共計32 天, 擔任主護護理師,在護理期間給予個案整體性護理,確立個案之主要護理問題為:一.疼痛/手術傷口。二.營養狀況改變:少於身體需要/與疼痛有關。三.現存性感染/手術傷口及各類引流管留置。四.身體心像紊亂/現存身體結構喪失。五知識缺失:特定的/對迴腸導管照護不瞭解。六.個人應因能力失調/與迴腸導管有關。在近一個月的持續性護理期間,筆者運用整体性護理概念,採生理、心理、社會、靈性之評估方式,提供不同的專業角色與專業知識,協助個案適應及接受迴腸導管,進而成功的學會自我照顧,接納自我、恢復自信心並重回原有之生活角色。在整個護理過程中,深感、護理人員之角色扮演非常重要,願以此分享大家。
This report is present the nursing experience of carcinoma of ileo-ostomy, The author worked as primary nurse and cared the patient from June5 to July7, 1997 , Major nursing problems could be inculded :「1.Pain/related to surgical wound. 2.Nutrition change: inadequate for body needs/related to emotion and pain. 3.Persistant infection/related to surgical wound and retention of drainage tube. 4.Psychosomatic confusion/related to structure loss. 5.Knowledge deficient: Specific/poor knowledge on caring the ileo-ostomy catheter. 6.Poor personal adaptation/related to ileo-ostomy catheter.」 During this period, the author used holistic nursing concept to assess his need physical, psychological, social and spiritual In order to provide professional knowledge and help the patient to accept the ileo-ostomy catheter. Furthermore, the patient could successfully learn the technique of self-care, accept his role, recover his confidence and return to his original life-style.