運用藝術治療照護一位乳癌婦女之護理經驗

Providing Art Therapy to a Breast Cancer Woman: A Nurse's Experience

蔡惠貞(Hui-Chen Tsai) ； 袁千邑(Chien-Yi Yuan)

《腫瘤護理雜誌》 10卷1期 (2010/06) Pp. 53-64

https://doi.org/10.6880/TJON.201006_10(1).05

摘要

本文主要描述一位從事造型設計師的單親媽媽接受乳癌手術前後之護理經驗。個案因住院前三個月意外發現右側乳房腫塊，回國檢查時確立診斷為乳癌，並接受右側改良性全乳根除術。筆者於2007年6月14日至6月22日護理期間以會談、觀察、身體評估等收集資料，運用羅氏適應模式做為評估指引，發現個案有1.急性疼痛；2.皮膚完整性受損；3.身體心像紊亂；4.焦慮等問題。因個案原本旅居國外，是一位相當時髦前衛的服飾設計者也是個獨立性強的單親媽媽，突如其來的疾病令她措手不及，且情緒低落導致無法接受治療。故護理過程期間為達到全人照護的護理目標，除針對生理問題之皮膚完整性受損及傷口疼痛，教導傷口自我照護、降低敷料所引起的皮膚反應和利用止痛劑減輕傷口疼痛外，特別運用藝術治療轉移其術後疼痛、焦慮和恐懼的情緒；也藉由服裝美學的創作重新建立自信，使能接受身體外觀的改變，協助個案克服因疾病所帶來的壓力與衝擊，更能積極接受治療進而能恢復其原來生活型態。藉此護理經驗與大家分享以提供護理人員日後照護此類病患之參考。

關鍵字

羅氏適應模式 ； 乳癌 ； 藝術治療

並列摘要

This article mainly describes the nursing experience of a before and after breast cancer surgery of the single mother in fashion design. The patient accidentally found a mass on her right breast three months before coming back to Taiwan. The doctor confirmed the diagnosis of breast cancer when she came for examination. And the right modified radical mastectomy (MRM) was performed right after. The author collected all the data through interview, observation and physical assessment with Roy's adaptation model during June 14 to June 22, 2007 nursing period. The findings were: 1. Acute pain; 2. Impaired skin integrity; 3. Body image disturbance; 4. Anxiety. The patient lived abroad and was a very fashionable fashion designer and a very independent single mother. She was caught off guard with this sudden illness, and her depression and confusion had caused her not to be able to receive the therapy treatment. Therefore, during the nursing process to achieve the goal of holistic nursing care, in addition to physical problems for impaired skin integrity and wound pain; teaching wound self-care; reducing skin reactions caused by dressing and use of analgesics to reduce wound pain; the Art therapy in particular to distract the postoperative pain, anxiety and fear. Also to re-establish her confidence by the creation of aesthetic costume; enabling her acceptance of the appearance change; helping the patient overcome pressure and impact from the disease, so she can be more active to receive the treatment and then to restore her original lifestyle. By sharing this nursing experience with you in order to provide the medical staff for nursing care of this kind in future reference.

並列關鍵字

Roy's adaptation model ； breast cancer ； art therapy