一位卵巢癌復發病患經歷手術治療後之護理經驗

A Nursing Process of Caring a Patient with Recurrent Ovary Cancer Underwent

癌症復發病患所衍生的情緒反應，可阻撓其對後續治療計劃的信心與動力，更甚者引發病患對醫護人員的敵對與不信任，本篇報告描述一位卵巢癌復發病患入院行婦癌減積手術後的護理經驗，期藉由積極緩解個案生理苦楚的過程來取得個案的信賴，同時處理個案面臨癌症復發所衍生的哀傷、無望情緒，促使個案適應卵巢癌復發所造成的身心問題。運用Gordon十一項功能性健康型態模式進行整體性評估及確立問題，結果發現個案現存之護理問題包括：排便型態改變／腹瀉、預期性哀傷以及無望感。生理症狀緩解方面，筆者藉由給予非侵入性的症狀支持療法，如：輕柔按摩腹部、給予薄荷油塗擦等緩和護理措施，有效緩解個案之腸胃不適。心理支持部分，筆者運用溝通策略，如：開放性問答、反映個案情緒等，促進哀傷過程的進展；同時引導個案注意身旁的豐富資源，使其感受到愛與被愛、安全與歸屬，進而萌生希望。經此個案之照護經驗，筆者分享兩個成功的策略是：「優先處理個案的生理不適」以及「同理個案的憤怒哀傷情緒」，可作為臨床上照護此一案例之參考。

The impact on the mind from a patient with recurrent ovary cancer would decrease the confidence and energy for future treatment. The hostility would be induced to cause a patient difficult to confide in health providers. This article shared the nursing process of caring a patient with recurrent ovary cancer who underwent surgery treatment. The article emphasized the importance of urging a patient to adjust to illness by relieving her physical suffering and supporting her psychological maladjustments related to recurrent cancer. During nursing process, the Gordon’s eleven-items functional evaluation of health assessment model was used to gather the information and identify the nursing problems. Three major problems were identified as following: diarrhea, anticipatory grieving and hopelessness. We practiced gentle massage to diminish patient’s intestinal upset, communicated with her by using open question sentences to encourage her to express, and guided her to notice the rich resources she owns to produce a desire. Based on this article, the two successful nursing care tactics in this case report were first to solve patient’s physical upset and moreover, to fell sympathy with patient’s anger and grief. We hope the nursing experience would be a valuable reference for taking care of such cases.