運用歐倫（Orem）理論照顧一位口腔癌術後病患護理經驗

A nursing experience of care an oral cancer patient after surgery by the application of Orem's theory

10.6540/NTJN.2016.1.011

張宥琳(You-Lin Chang)；廖恩淑(En-Shu Liao)

歐倫自我照顧理論 ； 口腔癌術後 ； 自我顧能力缺失 ； Orem's self-care theory ； Oral cancer surgery ； Lack of self-care ability

新臺北護理期刊

18卷1期（2016 / 03 / 01）

125 - 133

繁體中文

本文探討一位50歲男性，口腔癌個案接受腫瘤切除，術後氣切套管留置及皮瓣重建手術的照護經驗，護理期間從2012年3月24日至4月20日。筆者藉由直接照護觀察、會談、身體評估等方式收集資料，並運用Orem（歐倫）自我照顧理論進行評估；確立個案有自我照顧能力缺失、口腔黏膜改變、身體心像紊亂、言詞溝通障礙等健康問題。護理期間中，筆者依據健康問題提供完全代償性的護理活動、部分代償性的護理活動、支持教育性的護理活動之個別性護理措施，減輕疾病所帶來的生理不適；建立信任感後，透過良好護病關係，給予支持鼓勵；運用紙筆及共同擬定圖字卡，讓溝通更順暢；引導個案與外界接觸，提昇個案自我正向感，進而改善其生活品質。筆者於照護過程中深刻體會到唯有深入瞭解個案身心靈各層面之問題，方能發揮護理獨特的功能，也期盼此照護經驗能做為其他護理同仁工作時之參考。

This paper discussed a nursing experience of a 50-year-old male, patient who suffered from oral cancer and faced tumor excision, postoperative indwelling tracheostomy tube, and flap reconstruction. Data were collected from March 24 to April 20, 2012 by using direct observation, interviews, and physical assessment and evaluation by applying Orem self-care theory. Identified health problems were self-care deficit, oral mucosal changes, body image disorders, and verbal communication disorders. During the nursing period, the author provided individual nursing care, including wholly compensatory nursing, partly compensatory nursing and supportive-educative nursing based on the health problems to alleviate the physical discomfort caused by the disease. After the author gained trust from the patient, support and encouragement were given to him through good nurse-patient relationship, such as using pen and paper and developed picture word cards to help the patient communicate more smoothly and contact with the outside world, thereby improving the positive sense of self and quality of life. In the process of care, the author realized that the unique nursing function could be performed well depending on a deeper understanding of the patient's physical and psychological problems at all levels. It is expected that this experience can be the reference for other nursing colleagues who help similar patients.

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