一位青壯年直腸癌併急性腸阻塞病人之護理經驗

A Nursing Experience of a Young Adult Patient with Rectal Cancer Complicated by Acute Intestinal Obstruction

陳遴鞠(Lin-Jiu Chen)；胡馨方(Hsin-Fang Hu)；李文馨(Wen-Hsin Lee)；陳繪竹(Hui-Zhu Chen)

青壯年期 ； 直腸癌 ； 腸造口護理 ； colostomy care ； rectal cancer ； young adult

志為護理-慈濟護理雜誌

17卷5期（2018 / 10 / 01）

123 - 132

繁體中文

本文為一位青壯年期長期居住在菲律賓，初次診斷為直腸癌的個案（臺商），因急性腸阻塞先行腸造口手術，後接受同步化學藥物治療和放射線治療之護理經驗。護理期間為2015年9月1日至9月16日，筆者以Gordon十一項健康功能型態進行評估，透過直接照護及資料收集，發現個案有焦慮、身體心像紊亂及知識增進準備度等健康問題。照護過程中，藉由傾聽、鼓勵與支持方式，提供疾病醫療知識及護理照護、澄清治療疑慮及解決短暫居住需求，協助個案以正向的態度正視自己外觀的改變，並主動參與治療計劃及腸造口的自我照護。於個案出院後進行電話訪談，達成遠距離且無國界的持續性照護，藉此經驗分享提供臨床護理人員參考。

This article reported a nursing experience of a young adult patient, a Taiwanese businessman living abroad in the Philippines, undergoing colostomy and concurrent chemo-radiotherapy after an initial diagnosis of rectal cancer complicated by acute intestinal obstruction. The nursing period lasted from Sept. 1^(st) to 16^(th), 2015. With Gordon's 11 functional health patterns as an assessment tool, the patient's health issues were identified through direct care and data collection as anxiety, body image disturbance, and readiness for enhanced knowledge. During the nursing period, by listening, encouraging, and supporting, we provided the patient with knowledge on the disease, nursing care, addressed the patient's concerns on the treatment, solved the patient's need for a short-term accommodation, aided the patient in facing the change in physical appearance with a positive attitude, and actively participated in the treatment plan as well as colostomy postoperative care. The discharge follow-up by telephone allowed the team to provide a continuous care through long distance and beyond borders. We would like to share this experience as a reference for other clinical nursing staff.

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