一位胃癌病人接受次全胃切除術之手術全期護理的經驗

Perioperative Nursing Experience of a Gastric Cancer Patient who Received Subtotal Gastrectomy

本文主要描寫一位胃癌病人接受次全胃切除手術之手術全期護理的經驗，筆者於2006年9月24日至10月3日護理期間藉由觀察、訪談、傾聽等方式，以Orem的自我照顧缺失護理理論作為指引，與病人建立治療性的人際關係，針對生理、心理、社會及靈性層面分析歸納主要的健康問題有：焦慮、體溫過低、疼痛、特定知識缺失等；筆者以手術全期護理概念，並透過術前給予訪視提供正確手術資訊，強化對疾病與治療的認知及居家照護的技巧等護理活動的介入，改善身心的問題，且陪伴病人及家屬渡過手術危機，進而提升因應能力，在病人出院返家後持續四次的電話追蹤訪問，以確認病人能遵循衛教重點並執行自我照顧；將此護理經驗提出分享，期望往後對於有關胃癌手術病人之手術全期護理照護上有所助益。

A 76-year-old female patient who had gastric cancer received subtotal gastrectomy. During the hospitalization period from 24, September 2006 to 3, October 2006, the author started the perioperative nursing care with observation, interview and listening. Based on Orem’s theory of self care, the patient’s need was evaluated in four different aspects, physiological, psychological, social, and spiritual. The patient’s problems included anxiety, hypothermia, pain, deficiency of pertinent knowledge. Provision of correct information of the surgery in preoperative visit, cognition of disease and treatment, introduction of techniques of home self care, understanding of the patient’s psychological need, and getting through the critical period with the patient and the family are crucial to the patient who would need to adapt the altered life style. After discharge patient’s compliance to self care instructions were confirmed through four regular telephone follow ups by the author. We hope that this nursing experience would contribute to the improvement of nursing care for gastric cancer patients who would receive gastrectomy.