一位年輕女性罹患惡性葡萄膜黑色素瘤接受眼球摘除手術之照護經驗

The Experience of Postoperative Care for a Young Female Patient of Malignant Uveal Melanoma after Enucleation

本篇旨在描述一位年輕女性罹患惡性葡萄膜黑色素瘤，接受眼球摘除手術所造成的視覺缺陷及罹癌威脅心理衝擊之護理經驗。照護期間於2012年4月3日至2012年4月15日護理過程中以直接照護、傾聽、會談及觀察等方式蒐集相關資料。筆者依Gordon十一項功能性健康型態進行評估，確立個案有焦慮、急性疼痛、身體心像紊亂等問題；透過有效的溝通，與個案建立治療性人際關係，鼓勵個案說出心裡的感受，並針對其對疾病的疑慮，提供完整的資訊，並予正確的衛教加強個案對疾病和療程的認知，協助解決健康問題，引導個案積極參與治療計劃，有效地讓個案調適身體外觀變化並適應新的生活型態，希望藉此照護經驗分享，提供護理同仁臨床實務參考。

This article described the experience of postoperative care for a young female patient who suffered from malignant uveal melanoma and received the operation of enucleation, which not only caused the patient’s visual-impairment but also created her psychological impact of developing a cancer. The nursing period was from April 3 to April 15 in 2012, and relevant information was collected from direct care, listening, interviewing, and observation of the patient. The author evaluated the patient by Gordon 11-Item Functional Health Patterns and confirmed the patient had several problems including anxiety, acute pain, and body image disturbance, etc. Moreover, in order to encourage the patient to express her true inner feelings and to provide patient complete information, the therapeutic interpersonal relationship was established with effective communication between the patient and the author, so the latter, the nurse, could offer the patient some accurate health education, to enhance knowledge regarding the disease. Furthermore, the author also assisted the patient to solve both mental and psychological problems, and then guided the patient to actively participate in treatment, to help the patient adjust to the changes in life caused by her visual impairment. It is expected that this unique nursing experience described in this paper can serve as an example of clinical practice for reference in the field of nursing.