照顧一位年輕未婚女性罹患卵巢癌之護理經驗

Nursing Care for a Young Unmarried Woman with Ovarian Cancer

10.6880/TJON.202012_20(2).07

李晨郁(Chen-Yu Li)；彭月珠(Yueh-Chu Peng)

年輕未婚女性 ； 卵巢癌 ； 護理 ； young unmarried women ； ovarian cancer ； nursing

腫瘤護理雜誌

20卷2期（2020 / 12 / 01）

59 - 68

繁體中文

本篇為描述一位25歲罹患卵巢癌未婚女性，因手術生殖器官被切除，身心承受巨大衝擊的護理經驗，護理期間自2018年1月7日至2018年1月19日，運用Gordon十一項健康功能評估，以直接護理、會談及觀察等方式，進行生理、心理及社會層面之資料收集及分析，確立個案有急性疼痛、潛在危險性感染、身體心像紊亂等護理問題。護理過程中，藉了解個案喜好，利用精油按摩，增進個案舒適度，在急性疼痛時，搭配藥物使用，並教導轉移注意力以減輕疼痛；對於潛在危險性感染問題，協助每日傷口換藥，教導傷口感染徵象、衛教攝取高蛋白飲食及返家後傷口照護方法；藉主動關懷與個案建立良好的護病關係，予以傾聽與支持，並提供網路社群支持團體、鼓勵表達自己想法、寫下心願便利貼，使其能減少因卵巢切除造成之負向情緒感受。在此照護過程中，深感院內整合性癌症中心，雖常規舉辦各癌症病友會，但缺針對年輕婦癌患者之支持團體，此群患者，極易因喪失懷孕與生育能力而感到焦慮，故建議院內能於網路粉絲團建立年輕婦癌病友會，提供病人心情抒發及心路歷程的分享，以期能長期陪伴病友們渡過此艱困之歷程。

This report describes the experience of providing nursing care to a 25-year-old unmarried woman who experienced great physical and mental shock from the resection of the reproductive organs. During the nursing care period, from January 7 to 19, 2018, Gordon's eleven functional health patterns was used for assessment. Data at the physiological, psychological, and social levels were collected and analyzed through direct care, interviews, and observations. It was confirmed that the patient experienced issues such as acute pain, risks of severe infections, and body image disturbance. Based on the preferences of the patient during the nursing process, essential oil massage was used to improve the comfort of the patient, medication was used for acute pain. The patient was instructed to divert attention to relieve pain. For the potential risks of severe infections, the patient was assisted in daily replacement of wound dressings, educated on signs of wound infection, directed to adopt a high-protein diet, and instructed to take care of wounds after returning home. We established a good nurse-patient relationship by showing compassion, listening to and supporting the patient. We also provided online community support groups to encourage the patient to express her thoughts. For instance, we asked her to write down her wishes on small cards (one wish per card) and placed them in a notebook or on a board as they are achieved. The action of tearing off the small cards can help reduce the negative emotions caused by oophorectomy. During this nursing process, it is strongly suggested that the integrated cancer center should add to the various existing cancer patient support groups one that is expressly for young women. This young patient population is particularly vulnerable to anxiety and depression because of the loss of ability to bear child. Therefore, it is recommended that hospitals establish online cancer support groups for young women to allow the patients to open up about their feelings and share their emotional journeys, with hopes to support the patients in this difficult long journey.

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