協助一位直腸癌婦女置放人工肛門術後之護理經驗

A Nursing Experience of a Female Patient with Rectal Cancer Receiving Colostomy Surgery

本文描述一位直腸癌婦女，入院行腫瘤切除並放置左側大腸造口，術後轉入加護病房照護，於2013年1月26日至2月1日護理期間，以會談、觀察及運用Gordon十一項功能性健康形態評估，確立個案有急性疼痛、睡眠型態紊亂、身體心像紊亂等護理問題。以整體性評估，找出影響因素，提供術後疼痛護理，運用家屬支持與醫療團隊的合作，以轉移注意力、減輕疼痛不適，而獲得足夠的休息及睡眠；利用衛教單張，提供術後自我照護資訊，提供成功案例照護經驗，協助紓解壓力；並鼓勵個案與家庭成員溝通，以維持親密關係，提升個案人工肛門術後身心適應，進而重新回復以往的生活型態。

The article described a nursing experience of a female patient with rectal cancer from January 26 to February 1, 2013. The patient was transferred to ICU after undergoing tumor excision and left colostomy device placement. During the nursing period, the author assessed and analyzed the patient, under the framework of Gordon 11 functional health patterns, by interviews and observations, and confirmed that the major nursing challenges were acute pain, sleep disturbance, and body image disturbance. The author introduced a series of nursing interventions: postoperative pain management, coupled with family support and medical team collaboration, to allow the patient to have sufficient rest and sleep by shifting attention and relief pain; utilize health education brochure with postoperative self-care instructions and successful cases of previous nursing experiences to relief stress; and encourage communication between the patient and her family members to maintain close relationship. Through the above measurements, the patient's physical and mental accommodation to post-colostomy was improved, and was able to return to her daily routine.