照護一位全喉切除術後患者之護理經驗

Nursing Experience of a Patient with Total Laryngectomy

本篇個案報告主要是在探討一位67歲男性喉癌患者，術後面臨生理及心理上不適應之護理經驗。護理期間自89年9月29日至89年10月15日，筆者以羅氏適應模式進行護理評估，發現個案主要護理問題有：呼吸道清除功能失效、疼痛、身體心像紊亂及個人因應能力失調等。護理重點主要著重在術後維持呼吸道通暢、維持身體舒適、鼓勵及運用支持系統，協助個案適應及調適無喉情形。此個案在出院前，上述護理問題皆有明顯的改善。筆者藉電話訪談及參與無喉關懷團體活動，發現個案出院後，對其疾病預後採正向的看法，學會自我調適及控制，並使用人工語對談，適應新角色及新生活。

This case study reported the nursing experience of a 67 years old man who underwent total laryngectomy after being diagnosed as laryngeal cancer. Roy's adaptation model was used for nursing assessment during Sep., 29 to Oct, 15, in 2000. The results showed that the patient presenting dysfunction of the airway clearance, pain, change of the body image, and impairment of coping behavior. The nursing interventions focused on maintaining airway clearance, coping with the disease, and encouraging the patient using supportive system. Before being discharged, the above problems were improved significantly. After being discharged, the patient was able to face his disease with positive attitude and to use artificial language.