一位腎細胞癌患者接受根除性腎切除術之護理經驗

Nursing Experience of a Renal Cell Carcinoma Patient who Had Radical Nephrectomy

本文旨在描述一位罹患腎細胞癌行根除性腎切除術的護理經驗。筆者於護理期間(2007年12月17日至12月24日)、運用Gordon十一項健康功能型態為評估架構進行資料收集及分析，發現個案有焦慮、急性疼痛及身體心像紊亂等護理問題。筆者藉由良好的護病關係、陪伴與傾聽、鼓勵個案說出心裏的感受及針對其擔心之事，予詳細解釋及澄清疑惑之處，以降低焦慮之情緒、給予緩解疼痛的相關護理處置、澄清負向觀點，並鼓勵個案正視傷口及參與傷口照護，進而以正向觀點及行為面對身體改變。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。

The purpose of this case study was to report the nursing experience of a renal cell carcinoma patient with nephrectomy. The period of nursing care was from December 17th to 24th in 2007. The author used Gordon’s 11-item Functional Health Pattern Assessment to conduct data collection and analysis. There were several nursing problems such as anxiety, acute pain and body image disturbance. By a good nursing-patient relationship, the author encouraged the patient to explain her feelings and concerns. In order to solve the patient’s nursing problems, the author gave the patient explanations and clarified her doubts for reducing anxiety, gave pain managements for relief pain, and encouraged her to face the operation wound and do wound care to change her negative body image. The nursing experience can serve as a clinical reference for caring renal cell carcinoma patient with radical nephrectomy in the future.