照護一位大腸癌病人術後併行永久性腸造瘻口的護理經驗

The Nursing Experience of Caring a Postoperative Patient With Colon Cancer and Permanent Colostomy

10.6530/YYN.202209_16(S).0002

張蓉馨(Jung-Hsin Chang)；陳雅紅(Ya-Hung Chen)；周佳諦(Chia-Ti Chou)；李淑儀(Su-Yi Lee)

大腸癌 ； 腸造瘻口 ； 疼痛 ； 身體心像紊亂 ； colon cancer ； colostomy ； pain ； body image disturbed

源遠護理

16卷增訂刊（2022 / 09 / 01）

13 - 20

繁體中文

本文為探討一位78歲男性大腸癌病人接受手術治療併行永久性腸造瘻口的護理經驗，照護期間為2018年3月5日至3月15日。以觀察、傾聽、會談、Gordon十一項進行健康功能評估等方式收集資料，發現個案有知識缺失、急性疼痛、身體心像紊亂等護理問題。照護期間筆者運用同理心關懷個案、建立信任的護病關係，針對知識缺失的護理問題使用合適的教學影片，使個案能更加理解內容，透過正確疼痛護理評估，提供有效的術後疼痛控制照護，永久性腸造瘻口帶給個案身體心像紊亂的衝擊，使得原本健談外向的個案擔心原本的人際關係會受到影響，而有拒絕訪視之情形，筆者指導腸造瘻口照護技巧，鼓勵重要家人共同參與腸造瘻口護理，協助個案獨立完成腸造瘻口照護，並且重拾過去的平時休閒活動。期望透過此次護理經驗，在未來能提升大腸癌術後併行永久性腸造瘻口病人的生活品質，並提供給其他醫療人員參考。

This article is a nursing experience in caring for a colon cancer postoperative patient with a permanent colostomy. The duration of nursing care was from March 5 to March 15, 2018. We collected data by using Golden 11 functional and health assessment, observation and conservation, three major nursing problems were identified including deficient knowledge, acute pain, and disturbed body image. During the process of nursing care, initially we established a good relationship with the patient and encouraged him to express his feelings. We provided disease information and education to help the patient take care of himself. The wound pain was relieved by postoperative pain control and non-drug intervention. The colostomy on the abdomen disturbed patient's body image and made him refuse to meet his friends. We guided patient to face the change in the physical appearance via providing appropriate dressing and diet advice. Now, the patient could not only independently take care of the colostomy, but also began to meet his old friends. By sharing this successful nursing experience, we expected to enhance the life quality of the patients and can serve as a reference for healthy workers.

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