一位乳癌婦女面臨再次乳房重建之護理經驗

Nursing Experience from Caring a Breast Cancer Woman Facing Repeat Reconstruction Surgery

10.29494/LN.202206_23(2).0006

黃聖淑(Sheng-Shu Huang)；曾月英(Yueh-Ying Tseng)

乳房重建 ； 焦慮 ； 身體心像紊亂 ； 性生活型態 ； breast reconstruction ； anxiety ； body image disturbance ； an altered sexual activity pattern

領導護理

23卷2期（2022 / 06 / 01）

74 - 91

繁體中文

本文是探討46歲女性罹患乳癌，歷經乳房重建手術失敗、化學治療及標靶藥物治療後，又再次面臨乳房重建手術之護理經驗。護理期間自2018年8月5日至8月12日，運用Gordon十一項功能性健康評估進行資料收集，確立個案有手術前焦慮、組織完整性受損、身體心像紊亂及性生活型態失常等健康問題。藉由手術前後的訪視、手術過程陪伴與個案建立彼此信任的關係以降低焦慮。經由回覆示教及反覆學習與操作，讓個案與案夫學會觀察及護理傷口。鼓勵個案表達內心感受及案夫的陪伴下進而能適應外觀的改變。協助個案與案夫藉由觸摸重建的乳房及澄清術後性生活的疑慮，讓個案術後能享有更好的生活品質。

This case report discusses the nursing experience of caring a 46-year-old woman suffering from breast cancer and facing breast reconstruction surgery once more after the initial breast reconstruction surgery failed, as well as chemotherapy and targeted drug therapy. The authors collected data by applying the Gordon Eleven Functional Health Assessment Tools during nursing period in between August 5th to 12th in 2018. The results established nursing issues including anxiety before surgery, impaired tissue integrity, disturbance of body image, and abnormal sexual life pattern. The patient's anxiety has improved by building a trusting nurse-patient relationship through visits before and after operation, and accompanied during operation. Lead the patient and her husband observed and learned how to take care of the wound by teaching, learning and hands-on operation repeatedly. Encourage patient to express her perception after breast reconstruction, and accompany by her husband to adapt the changes of body appearance. In order to have a better quality of life after operation, the author assists the patient and her husband through touching the reconstructed breast and clarified the doubts about the postoperative sexual life.

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