照顧一位未婚育齡女性面對腸造口之護理經驗

Nursing Care Experience of an Unmarried Women Suffering from Colostomy

蕭薇玫(Wei-Mei Hsiao) ； 吳靜怡(Jing-Yi Wu) ； 許曉萍(Hsiao-Ping Hsu)

《臺大護理雜誌》 16卷2期 (2020/07) Pp. 76-87

https://doi.org/10.6740/NTUHJN.202007_16(2).0008

摘要

本文係描述照顧一位28歲未婚育齡女性，罹患大腸癌且術後留置腸造口個案的護理經驗。於2017年10月29日至11月9日護理期間，透過直接照護、觀察、會談、身體評估及查閱病歷等方式收集資料，確認個案有急性疼痛、身體心像紊亂、焦慮等健康問題，與病家共同擬訂個別性及整體性之護理計畫，照護措施包括：提供藥物及非藥物方式來緩解術後傷口疼痛；針對腸造口所帶來外形上的改變，鼓勵表達自身感受，且鼓勵個案參與自我照顧，並照會傷造口護理師，同時鼓勵個案男友參與照護計畫，共同討論對於未來親密關係與生育之影響，並提供腸造口病人懷孕相關資訊，使其能感到心安，進而重返罹病前生活。對於出院後造口照護及情緒支持，以電訪關懷追蹤個案恢復狀況，日後個案可能需接受後續治療，將衍生其他健康問題，故建議提供本病房電話諮詢及轉介給本院腫瘤個案管理師，降低其焦慮，以提供持續完整性的照護；針對護理實務方面，建議可設計指導查檢表，以漸進式指導病家，並安排雙週一次病友團體分享其生活經驗，並於出院後與傷造口照護門診銜接，期望經由此護理經驗之分享，供日後醫護人員照護之參考。

關鍵字

大腸癌 ； 腸造口 ； 未婚育齡女性

並列摘要

This study described a nursing experience of providing care for an unmarried woman who underwent colostomy after colon cancer surgery. The period of nursing care was from October 29 to November 9, 2017. Nursing assessments were conducted through direct care, observations, conversation, physical examination, and reviewing of the medical records. The main nursing problems were: acute pain, body image disturbance, and anxiety. Therefore, we developed a personalized care plan. First, we advise her about medical and non-medical approaches to relieve her surgical pain. Second, we consulted an ostomy specialist to teach her ostomy care for her body image disturbance. We encouraged the patient and her boyfriend to face the stoma and discussed the influence of ostomy care on their intimate relationship and the possibility for her to give a birth. We suggested that a checklist of ostomy care needs to be designed to evaluate the patient's learning progress. An ostomy patient support group can also be arranged for the patient, where she can learn more knowledge about ostomy care. We believe this experience can be a good clinical reference in the future.

並列關鍵字

colon cancer ； ostomy ； unmarried women of childbearing age