一位初次診斷口腔癌病患之照護經驗

Nursing Experience of a Patient with Newly Diagnosed Oral Cancer

10.6692/KJN.202104_38(1).0010

陳彥妤(Yen-Yu Chen)；詹雅惠(Ya-Hui Tsan)；鄭慧娟(Hui-Chuan Cheng)

口腔癌 ； 感染 ； 口腔黏膜改變 ； 身體心像紊亂 ； oral cancer ； infection ； oral mucous membrane altered ； body image disturbance

高雄護理雜誌

38卷1期（2021 / 04 / 01）

110 - 121

繁體中文

本文探討一位口腔癌個案，九年前得知口腔疑似有惡性腫瘤但未曾求醫，直到病情無法控制才至醫院，期間承受罹病壓力，以及面對腫瘤傷口導致之外觀改變，進而嚴重影響工作及生活品質，故為選案動機。於2017年6月8日至7月17日，以Gordon十一項健康功能評估，運用會談、觀察、直接照護、身體評估及查閱病歷等方式收集資料，確立個案有高危險性感染、口腔黏膜改變及身體心像紊亂之健康問題。照護期間增加個案自我照護知識技能，減緩口腔黏膜炎造成之不適，並運用同理心、傾聽、引導個案說出內心感受，利用持續性照護，使個案獲得更好的生活品質。建議往後遇相似案例，及早介入跨團隊人員及支持團體，幫助個案勇敢面對疾病，完成治療。

This article discusses a case with oral cancer that was discovered nine years previously. The oral cavity was suspected of having a malignant tumor, but this patient had not sought medical treatment until the condition became uncontrollable. During this period, the pressure of illness and the change of body appearance seriously affected his work and quality of life, so this case was chosen for discussion. Gordons 11 functional health patterns were applied to collect information through interviews, observations, and direct care from June 8th to July 17th, 2017. Body image disturbance, risk of infection and alteration of oral mucous membrane at nursing diagnosis were found, and during the care period, the author increased his self-care knowledge and skills, improved self-immunity, decreased the discomfort of oral mucositis, adopted empathic listening skills to guide the case to express his inner feelings, assisted him to build confidence and finally accept the change of body appearance. The effect of continuous care for this oral cancer case enabled the patient to have a better quality of life.

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