一位乳癌病人行乳房切除及重建手術之護理經驗

The Nursing Experience for a Breast Cancer Patient Who Had Received a Mastectomy and Reconstructive Surgery

10.6692/KJN-2011-28-1-5

陳秀月(Hsiu-Yueh Chen)；沈麗盆(Li-Pen Shen)

乳癌 ； 重建手術 ； 身體心像 ； breast cancer ； reconstructive surgery ； body image

高雄護理雜誌

28卷1期（2011 / 04 / 01）

47 - 58

繁體中文

本文為照護一位乳癌病人接受改良性根除性左乳房切除，並行橫向腹直肌肌皮瓣乳房重建手術之護理經驗。探討術前、術後所引發之護理問題，並呈現照護過程及經驗分享。筆者於2008年10月16日至2008年10月24日期間，運用高登(Gordon)11項功能性健康型態評估表，以觀察、會談收集資料，進行生理、心理、社會及靈性等方面之整體評估，確立主要問題有：焦慮、疼痛、潛在危險性感染、知識缺失及身體心像紊亂等，針對上述問題，擬定個別性、整體性及持續性護理計畫，與個案建立良好護病關係，引導其表達內心感受，提供適當護理措施，予適當的控制疼痛、情緒支持和鼓勵，助其提升自我照顧能力，達到預防感染和減輕身體心像紊亂的感覺，增強手術後的信心，以提昇生活品質。

The purpose of this article was to describe the nursing experiences for a breast cancer patient who had left modified radical mastectomy and transverse rectus abdominis myocutaneous flap breast reconstruction surgery. It explored the nursing problems before and after surgery and described the caring process and shared the experiences. From October 16 to 24, 2008, the author used Gordon 11 Functional Health Patterns Assessment Record to assess an overall function of physiology, psychology, society and spirituality through the collection of data by observations and interviews. The main problems included anxiety, pain, risk of infection, lack of knowledge and body image disturbance. To address the problems, individual, integral and continuous nursing plans and good nurse-patient relationship with the patient were established. The nursing plans included guiding the patient to express her feelings, and providing appropriate nursing interventions, pain-measures, emotional support, and encouragement. The goals were to help the patient enhance her self-care ability, prevent infection, ease the feeling of body image disturbance, strengthen her confidence, and enhance quality of life after surgery.