子宮頸癌復發病患面臨不確定感之護理經驗

An Experience Nursing an Uncertain Patient with Recurrent Cervical Cancer

本文係探討一位子宮頸癌復發病患，因為漏尿再次住院，面臨不確定感情形下，再次接受前骨盆器官摘除及膀胱造口手術之護理經驗。護理期間以直接照護、家庭訪視、電訪及門診追蹤，藉由觀察、會談及行為過程實錄等方式進行資料收集與分析。針對個案陷入不確定感的威脅、疾病復發之哀傷反應提供護理措施。其中不確定感與接受乳癌治療不確定感的病患研究結果相同，且術前得分顯著高於術後。護理人員除了主動提供資訊與正向支持鼓勵，必需評估其不確定感的程度及支持之資源，加強自我照顧之護理指導。家人的支持亦具有正向的影響，尤其是親密配偶的支持，將能減少不確定感之感受。

This article describes an experience nursing a patient with recurrent cervical cancer. As a result of urinary leakage after radical surgery, the patient underwent a second anterior exenteration and ileoconduit operation while experiencing emotional uncertainty. The nursing care involved a combination of direct care, home visits, telephone and OPD follow-up. Data collection and analysis followed via observation, conversation and the recording of behavioral processes. Nursing measures were taken to address the sense of threat induced by uncertainty and anticipatory grieving. We found the same sense of uncertainty that research has found to affect breast cancer patients, and found that it is similarly significantly higher pre-operation than post-operation. Besides providing information and supportive encouragement, nursing staff should evaluate the degree of uncertainty and the sources of support available to the patient, as well as improving nursing guidance for self-care. The support of family members, especially the spouse, is a form of positive feedback which may significantly reduce the degree of uncertainty.