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長庚護理

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篇名 一位擠尿管癌復發且合併腸阻塞患者之護理經驗
卷期 21:4=72
並列篇名 A Nursing Experience of an Urachal Cancer Recurrence-related Bowel Obstruction Patient
作者 陳嘉容張美珍郭雪敏
頁次 494-502
關鍵字 騎尿管癌腸阻塞手術前後護理urachal cancerbowel obstructionpre and post operative period nursing care
出刊日期 201012

中文摘要

本篇個案報告為探討一位罹患騎尿管癌且合併多處轉移的男性患者,因騎尿管癌復發造成腸阻塞而持續承受口惡心嘔吐的困擾及面對疾病未知治療的擔心。故於護理期間以Gordon十一項功能性健康型態之評估作為指引,經由與個案或家屬互動過程中,利用觀察、訪談的方式收集資料,歸納個案的護理問題包含:于街前是否要接受腸造口子街的決策過程,以及于術後傷口疼痛及腸造口所造成身體心像改變的問題。因此護理過程運用傾聽與同理心給予個案及家屬正面之持,提供腸造口相關資料與諮詢且分享國內外騎尿管痞子術成功案例,讓個案及家屬對腸造口能進一步認識以增加對于街的信心,減少擔心于術後照顧之焦慮,進而願意接受于術治療的決策過程,並於于術後提供相關之護理措施,減輕于術後傷口疼痛及協助解決腸造口所造成身體心像改變的問題。期望藉此護理經驗,作為往後護理此類患者身心方面之參考,以提供更通切性護理。

英文摘要

This case report described the nursing experiences of a male patient with urachal cancer combined with multiple metastases. Due to cancer recurrence-related bowel obstruction, the patient suffered from
nausea and vomits and mentally, he experienced anxiety resulting from concerns about subsequent treatments. We used the Gordon’s functional health patterns as a guidance to communicate with the patient and his family and collect information and associated nursing problems through observation and interviews. Primary nursing issues included decision dilemma about receiving colostomy, postoperative pain management, and alteration of body image as a result of colostomy. Thus, we applied active
listening and empathy to provide positive supports and encourage optimistic attitude for the patient and their caregiver. We also provided the patient with information about colostomy and shared the successful
experience of urachal cancer treatment with the patient. The overall goal was to enhance the patient’s understanding of colostomy, increase patient’s confidence about the surgical intervention, and alleviate
worry about postoperative condition, so he would be willing to receive the operation. Nursing procedures to alleviate patient’s postoperative pain and ameliorate the mental stress induced from colostomy were provided. We hope that the successful experience of this report can serve as a reference for caring similar patients in the future.

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