協助一位永久性腸造口患者自我照顧之護理經驗

A Nursing Experience of Assisiting Self-care for a Patient With Permanent Colostomy

身體結構、功能與外觀的改變對任何人來說都是極大的壓力，若不適時給予協助處理，將造成病患身心受損。本篇個案報告是描述一位直腸癌合併永久性結腸造口患者之護理過程，筆者於92年8月7曰至92年8月22日照護個案期間，運用Orem自我照顧理論評估，發現個案有疼痛、身體心像紊亂、健康維護能力改變等護理問題。應用主動關懷、同理、接受等支持技巧與個案建立治療性人際關係與信任感後，引發學習動機，肯定自我照護能力，協助個案適應身體心像之改變，接受自我，進而成功的學會自我照護，以重回社會生活。Alternations of body structure, physical function and appearance are extremely stressful to anyone. Without providing assistance and management in time, it will result in mental and physical damages of the the patient. This article is a case report describing the nursing process of a patient with rectal cancer and permanent colostomy. The author took care of this patient from 92-08-07 to 92-08-22. She applied Orem's theory of self-care to evaluate the patient and found out that he had some nursing problems like pain, disturbance of body image, alternation of ability in maintaining good health...etc. After applying supporting skills like active concerns, empathy and acceptance to build up a therapeutic relationship and trust, the author tried to induce patient's learning motivation, appreciate patient's ability of self-care, promote patient's adjustment in alternation of body image and self-acceptance; furthermore, to learn self-care successfully and finally return to the normal social life.