照護一位口腔癌反覆復發接受手術病人之護理經驗

Nursing Experience of Caring for a Patient with Recurrent Oral Cancer Undergoing Surgery

10.6647/CN.202409_31(3).0011

黃彩眉(Tsai-Mei Huang)；嚴美華(Mei-Hua Yen)

口腔癌 ； 皮瓣重建術 ； 無望感 ； oral cancer ； free flap reconstruction ； hopelessness

彰化護理

31卷3期（2024 / 09 / 01）

90 - 102

繁體中文;英文

本文描述一位52歲男性，口腔癌反覆復發接受手術之護理經驗，照護期間於2022年8月6日至8月27日，運用Gordon十一項功能性健康型態進行護理評估，確立個案主要健康問題有：急性疼痛、潛在危險性感染與無望感等。透過數字評估量表評估疼痛指數，並依醫囑給予止痛藥、提供穴位按壓及正念冥想，轉移對疼痛之注意力；術後傷口照護，每班執行傷口評估及無菌技術換藥，衛教術後傷口及自我照護注意事項，以降低感染機率；運用同理心及傾聽與個案建立信任關係，並引導說出內心感受及想法，透過醫護跨團隊照護、病友的正向情緒引導、正念介入及宗教信仰支持，能積極面對後續治療，以重拾信心，進而肯定自我存在價值感，以便早日回歸正常生活。建議日後醫療機構將正念冥想課程導入電腦資訊系統，透過多媒體教學及在職教育訓練－正念冥想之實務演練，提升護理人員之臨床技能，進而協助病人勇敢面對未來之生活。

This article describes the nursing experience of a 52-year-old male patient with recurrent oral cancer undergoing surgery. During the care period from August 6th to August 27th, 2022, the Gordon's 11 Functional Health Patterns were utilized for nursing assessment, identifying the main health problems as acute pain, potential risk of infection, and hopelessness. Pain index was evaluated using a numerical assessment scale, and pain relief medication, acupressure, and mindfulness meditation were provided as per medical advice to shift attention away from pain. Postoperative wound care included wound assessment and sterile dressing changes per shift, along with patient education on postoperative wound care and self-care precautions to reduce the risk of infection. Empathy and active listening were used to establish trust with the patient and guide expression of inner feelings and thoughts. Through interdisciplinary healthcare team collaboration, positive emotional support from fellow patients, mindfulness interventions, and religious faith support, the patient could face subsequent treatment positively, regain confidence, and affirm self-worth, aiming for an early return to normal life. It is suggested that future healthcare institutions integrate mindfulness meditation courses into computer information systems and enhance nursing staff's clinical skills through multimedia teaching and in-service training on mindfulness meditation, thereby assisting patients in bravely facing future life challenges.

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