一位舌癌病人顯微重建術後之護理經驗

Nursing Care of a Tongue Cancer Patient Receiving Microsurgical Reconstruction

台灣口腔癌盛行率逐漸增加，本文探討一位舌癌病人顯微重建術後之護理經驗，筆者在照顧個案期間，以Gordon成人健康功能型態進行護理評估，發現個案有口腔黏膜改變、言辭溝通障礙、身體心像紊亂等護理問題。筆者於護理過程中運用主動關懷、同理心、接受及支持等技巧，並藉由直接的照護確實執行口腔清潔以預防感染發生，移植皮瓣之觀察以確保重建手術的成功，並與個案建立良好的護病關係，協助其接受身體外觀、結構及功能的改變，並進而學習口腔護理及語言復健的技巧，以期早日能恢復日常生活功能，重建正向的自我概念。藉此護理經驗的分享，冀能提供日後護理同仁照顧類似病患時之參考。

Oral cancer has become increasingly prevailed in Taiwan. This case study reported the nursing experience of a tongue cancer patient receiving microsurgical reconstruction. Three major nursing problems were found by using Gordon's functional health assessment guide. They were altered oral mucous membrane, impaired verbal communication, and disturbance of body image. Active caring, empathy, acceptance, and support were applied to the patient. Nursing intervention included teaching mouth sanitary to prevent infection and observing flap to ensure operation success. A good nurse-patient relationship was built up with the patient and therefore established his acceptance of the change of body appearance. Furthermore, the structural and functional aspects of learning mouth care and speech rehabilitation were explained to the patient to promote his daily activity function and to reconstruct the positive self-recognition. This report provided nurses with a reference for caring similar patients in the future.