運用羅氏適應模式於一位接受永久性腸造口手術病人之護理經驗

A Nursing Experience of Applying Roy’s Adaptation Model on a Patient with Permanent Colostomy Surgery

本篇敘述一位年輕女性因低位直腸癌接受永久性腸造口手術的護理經驗，照護期間為2015年4月22日至5月20日止，筆者運用傾聽、觀察、會談、身體評估及羅氏適應模式進行相關資料收集，確立護理問題為：疼痛、身體心像紊亂、無望感。護理過程中運用按摩技巧、挑選喜愛音樂、選擇不同敷料，減少換藥次數，降低術後傷口疼痛；提供衛教手冊教導腸造口照護，增進自我照護技巧；適時給予支持及讚美、運用跨團隊照護及病友分享經驗，讓個案能接納外觀的改變，重建自信，正向思考。期望藉此護理經驗，提供同仁類似個案之照護參考。

This article described the nursing experience of a young female patient receiving permanent colostomy surgery due to lower rectal cancer. Nursing care period lasted from April 22 to May 20, 2015. The author collected data through listening, observation, conversations, physical evaluation, and applied Roy’s adaptation model to identify the nursing problems: pain, body image disturbance, and hopelessness. During the nursing period, the following measures were implemented to reduce postoperative wound pain: massages, favorite music selections, change wound dressing, and reduce the number of dressing changes. Other nursing measures, such as health education manual on colostomy care, timely supporting and compliment, interdisciplinary team care and patient sharing, were introduced to enhance self-care ability, establish self-confidence and positive thinking, and facilitate acceptance of appearance change. We hope this nursing experience could serve as a reference for our nursing colleagues when caring for similar patients in the future.