一位胃癌病患接受全胃切除手術之護理經驗

Nursing Experience of a Gastric Cancer Patient with Total Gastrectomy

本文主旨為描述照護一位胃癌病患行根除性全胃切除手術期間之護理經驗，筆者於護理期間（2004年11月4日至11月24日）運用Gordon 11項功能性健康型態進行資料收集與分析，發現個案於術前有焦慮之護理問題，術後則有急性疼痛、營養狀況改變：少於身體需要、知識缺失（返家後傷口照護、飲食指導、運動、用藥等居家生活自我照護注意事項）等護理問題。筆者藉由良好的護病關係，針對病患接受全胃切除手術於手術前提供相關資訊及護理指導，減輕個案焦慮程度；於術後給予緩解疼痛及滿足生理所需之營養需要等相關護理處置，針對預防感染及返家後傷口照護、飲食指導、運動、用藥等居家生活自我照護注意事項，則提供個別性的護理指導，以提升其手術後之生活品質，期盼藉由此篇護理經驗提供給日後照護類似個案之護理人員參考與分享。

This article described the nursing experiences of a gastric cancer patient with radical total gastrectomy. During the period of nursing care(2004/11/4~11/24), the author used Gordon 11 functional pattern to identify the nursing problems. The results showed that the patient had anxiety problem before operation. After operation, the patient had acute pain, altered nutrition: less than body requirements, and knowledge deficit (wound care, diet, exercise, medication, and post-operative home care). After good nurse-patient relationship has been established, the patient was provided with adequate information to decreases anxiety level before surgery. After surgery, the patient was provided with pain reliever and adequate nutrition. The patient was also instructed with wound care, dietary and exercise plan, medication use, and self-care skills. The report can be a reference for caring gastrectomic patients.