一位直腸癌行永久性結腸造口患者之護理經驗

Nursing Experience of a Patient with Permanent Colostomy

本文係探討一位直腸癌患者，在面對手術切除腫瘤及永久性結腸造口的護理過程。照護期間自93年6月15日至93年6月29日，筆者運用Gordon十一項健康功能評估，藉由觀察、會談及身體評估等技巧，收集個案之相關資料，整理分析後確認個案有恐懼、潛在危險性感染、身體心像改變及照顧者角色緊張等護理問題。在護理過程中，協助個案預防感染的發生，並扮演傾聽、支持及諮詢者的角色，引導其訴說擔心害怕的事，以及提供個案及家屬結腸造口自我照護之相關知識，減輕個案及照顧者之緊張及壓力，增進自我照顧能力，使個案重新調適身體心像改變所帶來的衝擊，重獲信心，早日回歸工作崗位。

This article explores the nursing process on a patient with diagnosed Rectal Cancer who faced the operation of resection tumor and permanent colostomy. During the period from June 15 to June 29 in 2004, The nurse assessed the patient with Gorden 11 Functional Health Status Assessment tool, collect the relevant data through observation , conversation and physical assessment and defined patient’s problems were fear , risk of infection , disturbed body image and caregiver role strain ,etc. The nursing intervention were prevented the infection from the patient , act as the role of listening , supporting and consulting, the patient shared about what his feared , offered the relevant knowledge about colostomy care to nurse and his family before discharge. The nurse empowered and promoted care knowledge and skill to patient and caregiver. The patient and his family adapted the illness and confused with his body image .The patient regain his self-confidence and return to work.