- 期刊
一位直腸單一潰瘍症候群病人之照護經驗
Nursing Experience of a Solitary Rectal Ulcer Syndrome Patient
摘要
本文描述一位直腸單一潰瘍症候群之個案接受乙狀結腸造口術之照護經驗。護理期間為2016年12月13日至2017年1月23日，並以觀察、會談、身體評估及直接照護等方式收集資料，確認個案有急性疼痛、身體心像紊亂及不確定感等健康問題。於照護過程中，除使用藥物緩解疼痛外，亦透過對於宗教信仰的依賴，教導聆聽佛樂及撥唸佛珠來轉移注意力以降低疼痛感；鼓勵正向的態度正視並接受自己外觀的改變，提供腸造口居家照護影片及衛教單張，鼓勵並適時讚美個案主動參與腸造口的自我照護，進而適應排便模式的改變，及早回歸日常生活軌道；面對突如其來的疾病與不熟悉的治療模式加上診斷過程中花費較長時間，對於無法預知的未來，其個案心理即產生不確定感，運用陪伴及傾聽技巧引導個案說出心裡感受，協同醫療團隊裡各領域專家解答個案疑慮，緩解其焦慮並提供整合性照護，期望藉此經驗，提供同仁對因疾病的突發而面臨生、心理衝擊的病人之照護上的參考。
並列摘要
This paper presents the experiences of caring for a case with solitary rectal ulcer syndrome receiving a sigmoidostomy. The period of nursing was from December 13, 2016 to January 23, 2017. Using Gordon's eleven functional health patterns as evaluation tool, as well as observation, interview, physical assessment and direct care, information was collected. It was confirmed that the case had the health problems of acute pain, body image disturbance and uncertainty. During the care process, in addition to using medication to alleviate pain, religious belief was utilized to help distract the case and reduce pain by instructing him to listen to Buddhist music and chant with Buddhist beads. The case was encouraged to develop a positive attitude to face and accept physical changes while enterostomy care videos and health education leaflet were provided. The case's active participation in enterostomy self-care was encouraged, and at the appropriate time, recognition was given so as to facilitate his adaptation to changes in bowel movement pattern in order to quickly return to normal life. When confronted with sudden illness and an unfamiliar treatment mode-in addition to the relatively long period of time required in the diagnosis process, and in regard to an uncertain future, the case developed feelings of uncertainty. Companionship and attentive listening skills were used to guide the case through revealing his inner feelings while professionals from various fields on the medical team were coordinated to answer the case's queries so as to reduce his anxiety and provide comprehensive care. It is hoped that these experiences will serve as a reference in the care of similar patients dealing with the physical and psychological impact of sudden illness.
參考文獻
延伸閱讀
- 謝榮賢、陳太其、梁金銅、王世名、張金堅、孫家棟（1998）。直腸單一潰瘍症候群：一例報告。台灣醫學，2(5)，520-525。https://doi.org/10.6320/FJM.1998.2(5).04
- 曾筱惠（2011）。照顧一位直腸癌患者之護理經驗。長庚科技學刊，(15)，81-90。https://doi.org/10.6192/CGUST.2011.12.15.6
- 徐子婷、陳幼貴（2019）。協助一位大腸直腸癌病人面對心理困擾之護理經驗。台大護理雜誌，15(2)，159-171。https://doi.org/10.6740/NTUHJN.201907_15(2).0015
- 陳碧雪、司淑英、黃憶如、陳家鳳（2021）。照顧一位原發性腸系膜靜脈硬化症併發結腸壞死的護理經驗。高雄護理雜誌，38(3)，75-86。https://doi.org/10.6692/KJN.202112_38(3).0007
- 莊涵淳、林素慧、黃春霞（2019）。The Nursing Experience of an End-Stage Rectal Cancer Patient。腫瘤護理雜誌，19(1)，77-89。https://doi.org/10.6880/TJON.201906_19(1).07