本文描述一位罹患乳癌接受乳房全切除手術後個案,面臨身、心衝擊之護理經驗。照護期間為2014年11月20日至11月27日,藉由觀察、傾聽、訪談及運用Gordon十一項功能性健康型態評估做為指引,收集主、客觀資料,分析歸納出個案主要有:焦慮、急性疼痛及身體心像改變等健康問題。照護過程中藉由主動關懷及陪伴,與個案建立信任之護病關係,運用其支持系統引導其表達內心感受,使能坦然面對疾病所造成的衝擊;術後評估其疼痛情形,運用放鬆技巧、維持舒適臥位及轉移注意力,以藥物及非藥物方式來減輕疼痛;協助其正視目前身體的需求,並鼓勵表達術後身體心像改變之內心感受,接受個案之負面情緒反應,幫助重建正向的自我概念,重新肯定自我的價值。期許藉此護理經驗的分享,提供護理人員日後臨床照護之參考。
This article describes the nursing experience for a breast cancer patient undergoing radical mastectomy surgery and facing severe physical and psychological l impact. The nursing period was from November 20th to 27th, 2016. Through observation, listening, conversation, and application of Gordon's 11 functional health types to evaluate, we concluded that this patient had problems of anxiety, acute pain, and body image change. By proactive care and accompaniment, we set up a good relationship with this patient. We encouraged this patient to present her own feelings, thus making her face this disease bravely. After the operation, we applied relaxation techniques, keeping her comfortable in a lying position, applying distraction and proper analgesics to attenuate the pain. We also helped her express her own needs and negative sentiments to rebuild positive attitude and self-value. We hope that through sharing this special nursing experience, we can provide a good reference for our colleagues caring for similar cases.