一位乳癌病人接受乳房重建手術後之身心照護

Physical and Psychological Care of a Breast Cancer Patient Receiving Breast Reconstruction During Postoperative Period

本文是探討一位33歲婦女，因罹患乳癌接受改良式乳房根除手術，五年後接受乳房重建手術而出現身心方面不適應的護理經驗。於照護期間以系統性的觀察及會談，以Gorden成人健康功能型態進行護理評估，發現個案有皮膚完整性受損、身體心像混亂及調適障礙等護理問題。透過護理活動之介入，促進傷口癒合，協助面對身體外觀改變及不確定感，並鼓勵加入支持團體，促使身心狀態達到有效的整合。藉此護理經驗的分享，冀能提供日後護理同仁照顧類似個案病患時之參考。

This case study reported the nursing experience of a 33 years old woman with breast cancer who received modified radical mastectomy, and after 5 years, received breast reconstruction. Three major nursing problems were found by using Gorden’s functional health assessment guide through systemic observation and interview. They were impaired skin integrity, disturbance of body image, and impaired adjustment. Nursing intervention included promoting wound healing, helping patient face the change of body appearance and uncertainly, and encouraging patient joining support group, to improve physical and psychological status and reach effective integration. This report provided nurses with a reference for caring similar patients in the future.