一位食道癌術後併食道皮膚瘻管之護理經驗

The Nursing Experience when Treating Esophageal Carcinoma Admitted for Wide Resectioning and Reconstruction

本文敘述一位68歲男性，因罹患食道癌入院接受食道重建手術，經加護單位十三天的照護轉至普通病房後所面臨的身心變化的過程。筆者運用Gordon十一項功能性健康型態為架構來評估個案，藉由觀察及會談收集資料，確立個案於照護期間的護理問題有：營養狀態改變/少於身體所需、組織完整性受損、睡眠型態紊亂、身體心像紊亂等。在照護過程中，除滿足個案的生理需求，亦透過與個案及家屬建立良好的治療性關係，針對心理層面提供持續性的護理措施，期望藉此個案之護理經驗與護理同仁分享。

This article describes the nursing experience when treating an esophageal carcinoma patient admitted for wide resectioning and reconstruction. After thirteen days of ICU care, the patient was transferred to an ordinary ward. The primary nurse used clinical observation, interviews and physical assessment guided by the Gorden 11-item Functional Health Pattern to identify the patient’s four major problems. These were impaired nutrition that was less than that required by the body, impaired tissue integrity, a disturbed sleep pattern and a disturbed body image. The experience described here is presented to provide a useful example to nurses who may have to treat such individuals in the future.