照護一位產後罹患卵巢癌併發腹水患者之護理經驗

本文旨在照護一位經產婦於產後因腹脹腹水嚴重，詳檢查後發現罹患卵巢癌併發腹水之照護經驗。於2017年12月11日至2017年12月20日照護期間，運用Gordon十一項功能性健康型態進行評估，經由會談、觀察及直接照護方式收集資料，確立個案有體液容積過量、焦慮及無力感三項護理問題。在照護期間，藉由監測血液中的電解質，並監測攝入排出量，給予飲食衛教單張，多採臥床休息緩解個案腹水腹脹之不適感；藉由主動關懷、同理心、鼓勵個案表達內心及身體之感受、耐心傾聽，鼓勵個案表達疑問，教導深呼吸及肌肉放鬆，減輕個案焦慮；主動給予疾病及醫療的訊息，協助個案了解疾病的進展、治療方式，轉介心理師於會談時給予負向情緒與壓力宣洩的時間及空間，鼓勵案夫共同陪伴及給予支持，改善無力感。建議照顧此類病人時，應使病人之家庭共同參與及決策，以減輕病人獨自面對及承受之心理壓力，將病人家庭之心理因素一併列為護理照護，以達全人護理。

關鍵字

卵巢癌；腹水；照護經驗

並列摘要

The purpose of this study is to introduce a nursing experience after caring for a postpartum patient, who developed severe abdominal distension due to ascites, but after detailed examinations was found to have ovarian cancer, complicated by ascites. During the nursing period (11th December 2017 to 20th December 2017,) Gordon's 11 Functional Health Patterns were adopted to evaluate the patient's condition. Data were collected via interviews, observations, and direct care, which confirmed that the case presented three nursing problems: excess fluid, anxiety, and feelings of helplessness. During the nursing period, the electrolytes in the patient's blood, as well as her intake and excretion, were closely monitored. In addition, dietary educational brochures were provided, and the patient was instructed to take bed rest as often as possible to alleviate the discomfort caused by ascites and abdominal distention. Multiple measures were introduced to relieve the patient's anxiety. This included active care, showing empathy, encouraging the patient to express her emotional and physical feelings, listening to her patiently, encouraging her to ask questions, and teaching deep breathing and muscle relaxation. The patient's feeling of helplessness was greatly relieved by supplying proactive information about the disease and the associated treatment and by assisting her to understand the progression and treatment approaches of the disease. She was also provided with time and space to release negative emotions and stress through psychological sessions and her husband was encouraged to accompany and support her. It is recommended that, when caring for such patients, the patient's family should be involved in the decision-making process, so as to alleviate the emotional pressure born by the patient alone. In addition, the psychological factors of the patient's family should be incorporated in the nursing plan, thereby providing holistic care.

並列關鍵字

Ovarian cancer ； Ascites ； Nursing experience

國際替代計量

照護一位產後罹患卵巢癌併發腹水患者之護理經驗

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