一位中壯年下咽癌術後病患及其主要照護者之護理經驗

The Nursing Experience of Caring a Middle-Aged　Patient with Operated Oropharyngeal Cancer

本文為一位中壯年男性因下咽癌術後外貌與溝通模式改變，女兒為主要照顧者倍感壓力，筆者強化雙方照護知能與因應能力之護理經驗。護理期間自2013年3月3日至10日，運用Gordon十一項功能性健康形態評估、直接護理、筆談及觀察進行評估，發現問題有呼吸道清除功能失效、身體心像改變及照顧者角色緊張。護理過程依需求增減抽痰次數，教導咳嗽技巧及自我分泌物抽吸，維持呼吸道通暢；關懷同理使其接受外貌改變，給予足夠時間學習非語言溝通技巧，建立與疾病共存的健康態度；漸進式教導照護技巧，提升照顧者能力與信心。

This article described the nursing care experience of caring a middle-aged patient with operated oropharyngeal cancer who suffered from the changed appearance and communication. His daughter, serving as his primary caregiver, felt stressful to take the responsibity for caring for him. In this case, the author improved their knowledge of care to cope with physical and psychological stresses. The period of nursing care was from March 3rd to March 10th, 2013. The patient was assessed using Gordon 11 function health patterns, with the data collected and analyzed through direct nursing care, writing and observation. The health problems identified included airway clearance dysfunction, body image disturbance, and the nervousness of the caregiver. Nursing care included frequent sputum suction as needed, instructions of cough and sputum suction skills, encouragement to help coping with the stress from altered body image, and accompanying the patient in learning the non-verbal communication skills. Building the right attitude lived along with the disease. We also provided stepwise guidance in boostering the caregiver’s confidence and ability of care. (Tzu Chi Nursing Journal, 2015; 14:3, 73-82)