一位家族性腺體瘜肉症患者之護理經驗

The Nursing Experience of a Patient with Familial Adenomatous Polyposis

本文旨在描述照顧一位患有家族性腺體瘜肉症病患，執行迴腸儲存囊袋與肛門吻合手術之護理經驗。護理期間自92年10月2日至92年10月19日，藉由觀察、會談及身體評估收集資料，並以Gordon 十一項健康性功能型態評估，確立個案護理問題有：焦慮、知識缺乏、睡眠型態紊亂、潛在危險性感染與排泄型態改變等。筆者在照護過程中，透過關懷、接觸及傾聽等技巧，與個案建立了良好的護病關係，並應用醫療團隊合作模式，協助個案及家屬面對及接受對疾病、手術的焦慮與不安。依據護理評估與診斷，提供合宜護理措施，緩解個案身體不適；評估個案需求，指導個案與家屬學習迴腸造口與囊袋傷口日常生活照護技能。並以電話訪談的方式，持續性追蹤個案返家後之適應情形，協助個案儘早回復原有之社交生活。希望由此護理經驗，做為日後照顧此類病患之參考。

This report described the nursing experience of caring a patient with familial adenomatous polyposis , and stapled ileal pouch -anal anastomosis. The nursing care duration was from October 2 to October 16, 2003. The primary nurse used clinical observation, interview and physical assessment guided by the Gordon 11-item Functional Health Pattern to identify the patient’s major health problems. There were four major nursing diagnoses, anxiety, deficit of knowledge, sleep disorder, risk for infection, and bowel elimination altered. During the caring period, we finally gained good therapeutic relationship between the nurse and the patient and the mode of medical team’s collaboration, to help this patient and make them to face this disease ,anxiety of the operation and unease from disease. According to the nursing evaluation and diagnosis, we provide a suitable nursing care to relieve the discomfort of this case, evaluating the need of the patient and teaching the patient and his family further care of his pouch. To Follow up the patient by telephone interview, we must be sure that he can regain his previous life. The experience is to be shared with our fellow nurses as a persuasive example.