一位牙齦癌病患外科重建術後之護理經驗

The Post-Reconstruction Surgery Nursing Experience of a Gingival Cancer Patient

本篇是探討一位52歲牙齦癌中年男性病患，接受外科重建術後的護理經驗。照護期間自2007年4月13日至5月1日，藉由觀察、系統性會談並運用Gordon十一項功能性健康型態進行護理評估。確立病患有呼吸道清除功能失效、口腔黏膜障礙、焦慮及身體心像紊亂等健康問題。在護理過程中，教導病患有效性深呼吸、咳嗽及背部叩擊，以維持呼吸道通暢；使用口腔評估指引檢查後，依病患個別性，提供適切口腔清潔及營養支持，改善口腔黏膜障礙；藉由主動關懷及提供疾病的相關知識，緩解其焦慮；最後給予情緒支持並鼓勵病患表達身體外觀改變的感受，增加自信來面對及調適身體心像的改變。期望藉此護理經驗的分享，能提供臨床護理人員照護此類病患之參考。The case report is a post-reconstruction surgery nursing experience of mid-aged male Gingival Cancer patient, from 4/13/2007 to 5/1/2007. The nursing assessments were implemented by the observation, the systemic conversation and the Gordon's 11 functional patterns. We found that the health problems of the patient had the ineffective airway clearance, the impaired oral mucous membrane, the anxiety and the disturbed body image. In the nursing process, we taught the patient to take a deep breath, to cough, and to backslap to keep the airway. After we used the oral assessment guide individually, we provided the proper oral sanitary and the nutrition to improve the impaired oral mucous membrane. To release the anxiety of the patient, we initiated to take care of the patient and to provide related information about the disease. To increase the confidence and adaptation of the disturbed body image, we also gave the patient emotional support and encouraged the patient to speak out the feeling about the appearance change. We hope that our nursing experience could provide useful information for the other clinic nursing staff to take care of the Gingiva Cancer patient.