照顧一位男性鼻咽癌術後身體心像改變之加護經驗

The Intensive Nursing Experience of a Male with Nasopharyngeal Carcinoma Related Changes in Body Image After Surgery

薛錡蔚(Chi-Wei Hsueh)

鼻咽癌術後 ； 身體心像改變 ； 疼痛 ； body image ； nasopharyngeal carcinoma ； pain control

志為護理-慈濟護理雜誌

21卷4期（2022 / 08 / 01）

107 - 116

繁體中文

本文一位男性鼻咽癌術後身體心像改變之加護經驗，個案未婚父母雙亡，術後獨自面對身體心像改變之壓力引發負向情緒，引發筆者探討動機。護理期間2019年3月11日至2019年3月24日，運用觀察筆談、傾聽陪伴、身體評估、病歷查閱收集資料，以生理、心理、社會、靈性層面評估，護理問題：「疼痛」、「呼吸道清除功能失效」、「身體心像改變」。運用藥物及非藥物輔助緩解疼痛；早期下床增加肺部擴張呼吸肌力、有效咳嗽排出痰液；透過鏡子自我觀察，病友經驗分享正向鼓勵，最終回歸正常生活。身體心像受生理、心理、社會影響，嚴重則自我概念產生低自尊、逃避現實等反應。建議照顧者應學習身體心像核心概念議題，早期察覺給予正向回饋。

This article describes the intensive nursing experience of a nasopharyngeal carcinoma male with postoperative body image change. This case faced the body image change alone, which resulted in negative emotions, triggering the author to discuss the motivation. The nursing period was from March 11, 2019 to March 24, 2019. I evaluated the patient through observation, written conversation, listening, companionship, physical assessment and reviewing clinical data. I confirmed the main nursing problems as pain, ineffective airway clearance, and body image change. The medical team used pharmacological and non-pharmacological interventions to help relieve the patient's pain. Early postoperative ambulation was applied to encourage the patient to increase lung expansion, strengthen respiratory muscles and effectively cough out the sputum. A trustworthy relationship with the patient was established. Through self-observation in the mirror, expressing ideas with patient sharing experience, and positive encouragement the case successfully returned to normal life. It is recommended that clinical caregivers should learn the concepts of body image care, and early detect the impact of body image issues on patients. I hope to share this individualized nursing experience with the medical staff caring for nasopharyngeal carcinoma surgery in the future.

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