一位子宮切除患者的手術全期護理經驗

Experience in Perioperative Nursing Care for a Patient Who Underwent Total Hysterectomy

本篇敘述一位子宮肌瘤患者，在面臨手術與身體不適的抉擇與衝突時，經多方諮詢下決定接受子宮全切除術的護理經驗。護理期間藉由觀察、會談、傾聽、及持續性的關懷，鼓勵個案說出心中感受，協助解決手術前、中、後面臨的問題；並以Gordon十一項功能性健康型態評估，確立個案術前有手術認知不足的焦慮，術中因麻醉及使用電燒止血而有潛在危險性傷害問題，及術後身體心像改變、疼痛等問題。筆者藉由不斷的給予病人支持；以專業溝通技巧提供個案正面的認知，及適時協助增加舒適感以減緩疼痛，而重建自信心，面對開刀後的身心適應問題。

This article explored the nursing care experience for a woman with myoma uteri. Facing the ambivalence between physical discomfort and risk of surgery, the patient consulted different opinions. The author helped her by encouraging the patient to express the inner feelings with attentive listening to patient's concerns. The emotional difficulties that the patient faced in the peri-operative period were gradually unveiled and finally she decided to receive total hysterectomy. According to Gordon's Functional Health Pattern Assessment, the author found that this patient had anxiety due to insufficient and incorrect knowledge about potential risk and harm of general anesthesia, electrically coagulation hemostasis, surgical pain, and psychosomatic and body image change after operation. The author consistently inspired the patient, offered comfort care, and provided timely help in relieving pain. By means of professional knowledge and communication skills, the author provided positive influence and helped the women establish her self-confidence to face the psychosomatic change after the surgery.