一位乳房惡性蕈狀傷口個案初次接受治療之護理經驗

A Nursing Experience in Caring for a Patient with Breast Cancer and Malignant Fungating Wound Undergoing Initial Treatment

10.6974/TCNJ.201202.0115

魏嘉儀(Chia-Yi Wei)；許美玉(Mei-Yu Hsu)

乳房惡性蕈狀傷口 ； 傷口症狀 ； 初次接受治療 ； 抉擇衝突 ； breast malignant fungating wound ； decisional conflict ； first treatment ； wound symptoms

志為護理-慈濟護理雜誌

11卷1期（2012 / 02 / 01）

109 - 118

繁體中文

本文為描述一位乳房惡性蕈狀傷口婦女，首度接受治療所引發身心反應之護理過程。護理期間自2008年6月19日至7月2日，運用Gordon十一項健康功能型態評估，確立個案護理問題有皮膚完整性受損、身體心像紊亂、恐懼及抉擇衝突。護理過程中藉由傷口照護技巧以控制滲出液、惡臭與出血情形，維持身體舒適及提供調適技能協助其身體心像重建統合；以主動、同理心關懷，建立護病信任關係，透過提供治療資訊及介紹成功病友經驗分享，引導個案參與整個治療決策過程，使得能降低面臨化學治療的恐懼，以正向的態度、願意參與決策並且接受治療。（志為護理，2012；11：1，109－118）

The aims of this article were to describe the physical and mental experiences and reactions of a female patient with breast malignant fungating wound undergoing her first rounds of chemotherapy. The duration of nursing care was from June 19th to July 2nd, 2008. Gordon’s Functional Health Patterns was used to assess the patient. The following nursing issues were identified: impaired skin integrity, body image disturbance, fear, and decisional conflict. We provided quality wound care in controlling wound odor, exudate, and bleeding; maintaining physical comfort and providing coping skills; assisting in the reconstruction of the patient’s self-esteem and body image. We took an active approach in providing empathy and building a trusting patient-nursing relationship. Through the provision of clinical information and the sharing of experiences by recovered patients, we were able to involve the patient in making well-informed clinical decisions, reducing her fears toward chemotherapy, and letting her face her illness with a positive and willing attitude.(Tzu Chi Nursing Journal, 2012; 11:1, 109-118)