照顧一位婦女因子宮肌瘤行子宮切除之護理經驗

The Experience of Nursing a Woman Who Underwent Hysterectomy for Uterine Myoma

子宮對台灣婦女而言，代表女性象徵與角色認同，喪失如同失去「女性的圖騰」，對其有著深厚的子宮情結，更認為沒有子宮就不是女人，對婦女身心而言，是種無形的傷害。本文為照顧一位48歲婦女，因子宮肌瘤面臨子宮切除手術，造成身體心像紊亂之護理經驗。護理期間自98年6月12日至6月21日，經由直接照護、觀察、會談、身體評估等方式收集資料，並運用Gordon十一項功能性健康型態評估為指引，發現個案在住院期間有四個主要健康問題，依時間排序為焦慮、身體心像紊亂、疼痛、性生活型態改變。筆者照顧過程中，與個案建立良好的護病關係，藉由個別性的護理措施，提供整體性、連續性的評估與照顧，同時給予關懷、鼓勵、陪伴與支持，協助個案接受身體結構改變，維持正向的身體心像及重建信心，以適應未來新生活。期望分享此照顧經驗，提供日後臨床護理同仁照顧此類個案之參考。

The uterus is the symbol of femininity for women in Taiwan. Women who lose the uterus feel that they are not real women. This article is about the experience of nursing a 48-year-old woman who underwent hysterectomy for a uterine myoma and which resulted in distortion of her body image. The nursing period was from 12 to 21 June, 2009. The researcher gathered information by direct nursing, observation, conversation and body evaluation. In addition, the researcher utilized Gordon's eleven functional health patterns as a reference, and found that the patient had four major health problems: anxiety, distorted body image, pain, and change in sexual lifestyle. During the nursing period, the researcher developed a good relationship with the patient. With individual nursing measures, the researcher provided holistic, continual evaluation and caring, as well as concern, encouragement, company, and support. The researcher assisted the patient not only in accepting the changes in body structure, but also in maintaining a positive body image and rebuilding confidence in order to accommodate to that change. By sharing the nursing experience, the researcher hopes to provide a reference to nursing colleagues who will look after this kind of case in the future.