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一位膽囊切除術後面臨疑似惡性腫瘤個案之護理經驗

Nursing Experience on a Patient Facing with Suspected Cancer after Cholecystectomy

摘要


本文描述一位行膽囊切除術過程發現十二指腸疑似惡性腫瘤病變,須轉院進行治療病人之照護經驗。筆者於民國2009年10月16日至2009年10月26日期間,藉由身體評估、會談及出院後電話訪談等方式收集資料,並以Gordon十一項健康功能型態評估,確立病人之護理問題為疼痛、營養狀況少於身體所需、知識缺失及不確定感。經提供身體舒適之照護減輕疼痛,提供術後飲食及傷口照護指導,與心理層面的關懷及支持,使病人可以正向面對疾病。癌症病人之心理、靈性照護之在職教育以及整合性癌症醫療團隊介入已是國內癌症照護的重要趨勢,對於病人心理重建過程是相當重要的。因此,醫護人員應積極參與癌症病人身心靈照護課程以及關懷及諮商技巧訓練,主動協助癌症病人處理靈性困擾及面對死亡。

並列摘要


This paper describes a nursing experience of a patient who undergone cholecystectomy. From October 16th to 26th 2009, data were collected through physical assessment, interviews and telephone follow-up after discharged from hospital. Gordon's 11 Functional Health Patterns Assessment was used to confirm four major nursing problems, which included pain, nutrition requirements less than body's demands, knowledge insufficiency and uncertainty. With provision of physical comfort, pain relief, diet supply after surgery and wound care guidance, and offering patients care and psychological support for alleviating their anxiety, the patient can positively confront all changes of the disease. By share this nursing experiencing, the author suggests that healthcare providers should actively involve in the cancer patients physical and spiritual care programs as well as caring and counseling skill training and take the initiative to help cancer patients to deal with spiritual distress and the face of death.

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