乳腺外派吉特氏症病患身體心像紊亂之護理

Nursing Care of Body Image Disturbance in Extramammary Paget’s Disease Patients

乳腺外派吉特氏症(extramammary Paget's disease, EMPD)是一種很少見的上皮內腺癌，病灶常發生於較為隱私的生殖器、腋下或胸部的皮膚，與乳房常見的派吉特氏疾病極為相似。病人確立診斷時，常有震驚、懷疑、否認、逃避等等情緒的反應，加上其好發於身體第二性徵的特質，常使得病人無法面對身體心像的改變。身體心像是每個人意識或潛意識裡對自己身體的看法。護理人員在照顧此類病人時，不僅要重視病人生理病理方面的護理，心理社會層面的照護也是不容忽視的。針對乳腺外派吉特氏症病患身體心像紊亂的護理主要是讓病患認識、接受且統合身體的改變，適時提供病患與家屬有關疾病與治療的正確認知，同時幫助病患重新適應身體心像改變後的生活。護理的目標與措施如下：1.使病人能察覺且接受身體心像的改變。2.提供諮詢澄清病患問題，建立正確的認知。3.提升社會支持力量，促進病患成功的適應改變。

Extramammary Paget’s disease is an uncommon intraepithelial adenocarcinoma usually occurring on the genital, axillary or thoracic skin. Due to the involvement of private area, it often strikes the patient on physical-psychological-social aspects. Body image disturbance often happens on this patient group. Body image is the expression that one person perceive himself/herself consciously and unconsciously. The major nursing goals of body image disturbance in extramammary Paget’s disease are: 1.enable the patient to perceive and accept change in his/her body; 2. provide information to help the patient recognize the disease correctly; 3. provide social support to assist patient successfully adapting physical change.