一位子宮頸癌行根治性子宮切除個案之護理經驗

A Nursing Experience of Caring for a Patient with Radical Hysterectomy

本篇敘述一位35歲女性罹患子宮頸癌第二期，行根治性子宮切除術面臨身、心衝擊之照護經驗。自2012年8月27日至9月4日藉由觀察、會談及身體評估等方式收集資料，依其生理、心理、靈性及社會層面執行整體性護理評估，發現個案有焦慮、急性疼痛、性生活型態失常及身體心像紊亂之健康問題。護理過程中與個案建立良好護病關係，運用音樂、模型及圖片輔助工真進行術前評估與訪視、說明相關資訊，以降低手術過程之焦慮。教導放鬆技巧、肌肉及穴位按摩等緩解方式，以降低疼痛及不適感。鼓勵個案及伴侶參與個別化的性諮商，學習健康及正確的性知識，引導正向的自我概念，建立自信心，重整身體心像，以達身心健康之狀態。期望藉此護理經驗分享，提供日後臨床照護之參考。

This report describes a nursing experience of caring for a 35-year-old female with stage II cervical cancer who received a radical hysterectomy. During the nursing period from August 27^(th) to September 4^(th), 2012, the author collected data through observation, interview, and physical assessment. The identified problems were anxiety, acute pain secondary to postoperation, an altered sexual activity pattern, and body image disturbance. The nursing interventions included establishing a good therapeutic relationship with the patient, completing a pre-operative assessment and interview, and providing surgery-related information to relieve the patient's anxiety prior to surgery. Specifically, the author applied assessment tools such as music, anatomy models and pictures. The author taught the patient relaxation skills, muscle massages, and acupressure for acute pain relief. The patient and her husband were encouraged to attend an individualized sex consultation to learn about healthy and correct sexual activities and build up a positive self-concept, self-confidence, and body image. The author hopes that this nursing experience can serve as a reference for other clinical nurses who may be caring for similar patients in the future.