照顧一位口腔癌患者之護理經驗

Nursing Experience of Caring for a Patient with Oral Cancer

本文旨在探討一位口腔癌病人，因換藥過程中傷口疼痛不適並出現傷口惡臭及出血情形所面臨衝擊與調適過程的照護經驗。於照護期間，與病人及家屬建立良好護病關係，透過觀察、會談、評估等方式收集資料，確立病人的健康問題有慢性疼痛、組織完整性受損、身體心像紊亂及無望感。藉由提供腫瘤傷口護理、緩解疼痛技巧等，讓病人及照顧者參與整個照護活動，進而能正向面對身體心像改變的事實；運用整合照護模式，協同營養師、病人管理師及社工師的專科照護，以提供營養補助、急難救助金及學產基金申請資訊，予經濟上部分補助減輕負擔。希望藉此照護經驗分享，期許能夠提供護理同仁往後照護類似病人之參考。

This case report describes nursing experiences and the adaptation process of an oral cancer patient, who underwent the process of wound dressing with pain, discomfort, wound bleeding and odor. The authors took care of the patient. Data was collected by using observation, interview, and assessment etc. The patient’s problems were identified including chronic pain、impaired tissue integrity、disturbed body image、and hopelessness. During the nursing care process that included providing wound care and pain relief skills to relieve the patient’s pain, the authors encouraged the patient and family to actively participate in the whole care activities. Finally, the patient could positively face the changes in body image. The authors also utilized the Integration care model, collaborated with the nutritionist, social worker and case manager, and provided support with nutritional subsidies, emergency relief fund and information of school property fund application. By sharing the experience of care, it is expected that the case report could guide nurses to take care of similar patient cases.