一位口腔癌病人於皮瓣重建術後面臨疾病不確定感之照護

An Experience of Caring for an Oral Cancer Patient Taking Flap Reconstruction With Uncertainty

10.6692/KJN-2017-34-2-11

曾佳敏(Chia-Min Tseng)；歐素妃(Ou Su-Fei)

口腔癌 ； 皮瓣重建手術 ； 疾病不確定感 ； oral cancer ； flap reconstruction ； illness uncertainty

高雄護理雜誌

34卷2期（2017 / 08 / 01）

121 - 132

繁體中文

本文主要描述一位口腔癌接受皮瓣重建手術後之個案，因擔心皮瓣重建手術是否成功、無法確定後續接受化學及放射線治療的時間以及擔心治療後癌症是否復發的不確定感，再加上皮瓣腫脹造成說話口齒不清產生焦慮之照護經驗。護理期間自2012 年8 月28 日至9 月11 日，照護期間筆者運用觀察、筆談及會談、身體評估及病歷檢索等方式收集資料，針對個案之生理、心理、社會及靈性等層面進行整體性的評估，將資料進行分析後確立出個案有「組織完整性受損」、「口腔癌皮瓣術後的不確定感」等健康問題。過程中運用跨領域之團隊資源，並擬定符合個案需求之整體性護理計畫，協助個案接受並適應身體功能構造的改變，以及提供完整治療資訊與病友支持，協助個案面對治療且減輕焦慮情緒，終能接受且面對疾病的適應過程。將照護過程撰寫成本篇報告，分享醫護人員做為照護口腔癌接受皮瓣重建手術病人之參考。

This paper describes the nursing experience with a patient who accepted flap reconstruction surgery. During the nursing period, the patient worried about the success of flap surgery, was unable to understand the procedure of chemical and radiation therapy, had uncertainty about cancer recurrence, and was filled with anxiety about slurred speech caused by flap swelling. Nursing data was collected from August 28 to September 11 in 2012, and the author assessed the patient's condition related to physiology, psychology, society, and spirituality by observing, writing, interviewing, recording of physical assessments, and chart review. In further analyzing these data, it was diagnosed definitely that the patient had health concerns such as tissue integrity impairment and uncertainty after the oral cancer flap surgery. Using the Team Resource Management, a nursing plan was designed that conformed to the patient's needs and helped her adapt to the changes of physical function and structure. Providing entire information of treatment and spiritual support helped the patient confront the treatment and relieve anxiety, then finally accept and confront the disease. The purpose of this paper is a reference and sharing of the nursing experience of caring for a patient who had oral cancer and accepted flap reconstruction surgery.

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