協助一位舌根癌病患及照顧者面對全喉切除手術之護理經驗

Nursing Experience When Assisting a Caregiver and Their Patient Who Had Undergone Total Laryngectomy due to Tongue Base Carcinoma

本文以Gordon十一項功能性健康型態，針對一位舌根癌行全喉切除的個案及其照顧者進行評估，了解術後面臨的功能改變及衝擊。經評估後所確認的健康問題包括照顧者角色緊張、呼吸道清除功能失效以及言詞溝通障礙。經由照顧過程協助個案適應術後的身心變化，介紹成功個案並轉介無喉復聲協會以及增進照顧者的居家照護能力，進而減輕病患及照顧者的不安情緒並促進疾病適應的過程。期望此經驗能協助護理人員增進全喉切除病患及其照顧者術後身心適應的照護。

This article describes a health assessment conducted by employing the Gordon 11 Functional Health Pattern on both a patient with tongue base carcinoma who had undergone total laryngectomy and the caregiver of this patient. The aim was an exploration of the post-surgery functional changes and mental anguish of the two individuals. Three main health problems were identified; these were caregiver role strain, ineffective airway clearance and impaired verbal communication. Through the care giving process, the authors not only helped the patient to adapt to the psychosomatic changes after surgery but also instructed the caregiver and aided the development of this person's home care skills. This nursing experience will help nursing staff to thoroughly understand the reactions of a patient following total laryngectomy as well as providing a basis for the effective enhancement of the home care skills of the caregiver of such a patient.