一位長期遭受婚姻暴力婦女罹患乳癌之護理經驗

An Experience of a Woman Suffering from Domestic Violence with Breast Cancer

陳淑梅(Shu-Mei Chen) ； 王琳華(Ling-Hua Wang) ； 師慧娟(Hui-Chuan Shin) ； 李碧月(Pi-Yueh Lee)

《高雄護理雜誌》 34卷3期 (2017/12) Pp. 69-79

https://doi.org/10.6692/KJN.201712_34(3).0007

摘要

本文描述一位長期遭受婚姻暴力婦女，於確診罹患乳癌後，接受右乳根除合併乳房重建手術之護理經驗。照護期間自2015年12月21日至12月25日，追蹤至2016年1月8日，運用整體性護理評估模式，以觀察、會談、身體評估及電訪等方式收集資料，分析個案有健康尋求行為/與缺乏傷口照護資訊有關、身體心像紊亂/與右側乳房切除造成身體外觀改變有關、長期性低自尊/與長期處於婚姻暴力傷害有關等健康問題。照護過程中，以教學光碟教導方式來增加個案傷口照護技巧；引導個案說出對身體心像改變的負面想法，並藉由美化服飾妝扮，修飾身體外觀，以改善其身體心像受損；協助個案找出自我的長處來肯定自我的價值、提高自尊感，能有信心面對未來的治療並規劃自己未來的人生。希望藉此個案的照護經驗分享，能提供護理人員作為照護此類個案之參考。

關鍵字

乳癌 ； 身體心像 ； 婚姻暴力 ； 低自尊

並列摘要

This paper describes the nursing experience of a woman with breast cancer, who had suffered from marital violence for a long time, and received right radical mastectomy and reconstruction. During the nursing period from December 21 to December 25 in 2015, and following her up to January 8 in 2016, data were collected by observation, interview, physical assessment, and telephone interview on holistic nursing assessment model. The health problems were identified with factors as follows: health-seeking behavior with lack of information of wound care, body image disorders with right mastectomy, long-term low-esteem with marital violence. During the nursing process, the patient was guided by educational video to deal with the wound care, to express her negative thinking toward body image change, and to encourage her to modify her appearance by appropriate clothes. The authors also helped the patient to identify self-strengths, confirm self-worth, and improve self-esteem. Thereby, the patient had confidence to face further treatment, and the ability to adjust and plan her future life. This case report could be used as a reference for clinicians in taking care of breast cancer patients receiving radical mastectomy and reconstruction.

並列關鍵字

breast cancer ； body image ； domestic violence ； low-esteem

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