一位睪丸壞死性筋膜炎男性接受行結腸造口手術之護理經驗

Experience of Caring for A Men with Necrotizing Fasciitis of the Testicle after Colostomy

張淳淳(Chun-Chun Chang) ； 陳繪竹(Hui-Zhu Chen) ； 張碧珠(Pi-Chu Chang)

《安泰醫護雜誌》 26卷2期 (2020/12) Pp. 15-28

摘要

本文主要探討一位睪丸壞死性筋膜炎之男性面對術後結腸造口存在之護理經驗。筆者照護期間為2017年4月1日至5月2日，藉由筆談、觀察等方式收集資料，並運用Gordon十一項功能性健康型態進行評估，確立健康問題有急性疼痛、身體心像改變、知識缺失、現存性感染。透過主動關懷、陪伴及傾聽建立良好的護病關係，護理過程中除了緩解生理上的疼痛外，也需重視心理上的焦慮，鼓勵個案說出內心想法，採取漸進方式衛教個案，增進個案對結腸造口的照護認知，提升自我照護技巧，幫助個案接受身體上的改變，使個案得以順利出院。期望藉由此護理經驗，提供同仁類似個案之照護參考。

關鍵字

壞死性筋膜炎 ； 疼痛 ； 身體心像 ； 結腸造口

並列摘要

The paper mainly explores the experience of caring a male patient with necrotizing fasciitis of the testicle who faced existence of stoma after colostomy. During the caring period from April 1 to May 2, 2017, the researcher collected information through handwritten notes on conversation with the patient, and also employed Gordon's 11 functional health patterns to assessment the patient's conditions. After evaluation, the established health problems were acute pain , body image disturbance, knowledge deficit and infection . Through active concern, accompanying and listening, good caring relationship was established with the patient. In the caring process, not only alleviation of the patient's physical pain should be done, his mental anxiety should also be reduced. The patient was encouraged to express his inner feelings. Healthcare education was step by step offered to the patient, increasing his caring knowledge of his stoma, and teaching him self-care techniques. These caring acts helped the patient accept his physical change. Eventually, the patient was discharged from the hospital smoothly. It is expected that through this caring experience, our colleagues are provided with a reference for caring of similar patients.

並列關鍵字

necrotizing fasciitis ； colostomy ； body image disturbance ； pain