照顧一位乳腺炎雙胞胎產婦成功哺餵母乳之護理經驗

The Nursing Experiences of Taking Care of a Mother of Twins Who Experienced Mastitis and Breastfed Successfully

本篇報告為描述一位乳腺炎雙胞胎個案成功哺餵母乳之護理經驗。護理期間由2017年7月17日至2017年7月21日止，筆者運用Gordon十一項健康功能型態作為評估架構，進行生理、心理及社會層面之健康功能型態的資料收集及分析，確立個案有急性疼痛、焦慮、知識缺失、潛在危險性感染等護理問題。護理過程中，藉了解個案喜好，營造舒服及安全的環境，增進個案舒適度，在急性疼痛時，搭配藥物使用，教導轉移注意力及有效移出乳汁的方法，並協助刮痧，以減輕疼痛；藉著主動關懷與個案建立良好的護病關係，予傾聽、支持個案內心感受，針對疾病有疑慮處，協助聯絡醫師，提供諮詢管道，澄清疑惑以面對問題，並教導可尋求之資源，使個案能減少焦慮並以較正向的態度面對乳腺炎；也提供返家後預防乳腺炎再次發生注意事項，以提升其返家後的生活品質。照護過程中，深感病房針對產後婦女，常規會提供脹奶之衛教單張，但卻無針對乳腺炎的書面衛教，故建議病房能建立乳腺炎標準化之衛教手冊，提供病人及家屬更進一步的認識乳腺炎發生原因及其返家後照護注意事項，減少其發生及再發生率。

This case report described the nursing experience of caring a mother of twin who experienced mastitis and breastfed successfully. The caring period was from July 17 to July 21, 2017. Data which included physiological, psychological, and social dimensions were collected and analyzed by the assessment tool of Gordon's 11 health functions model. Four main domains of health problems were determined: acute pain, anxiety, deficient knowledge, and risk for infection. To alleviate acute pain, the author provided a comfortable and secure environment, used analgesics, distracted attention, effectively removed breast milk, and scraped. To reduce patient's anxiety, the author established good relationships with the patient to listen to her inner feelings. To increase mastitis knowledge, the author also provided points for attention for preventing mastitis recurrence to improve the quality of life after returning home. During the care process, the author found that written education material for mastitis was lacking. Therefore, it is recommended that a pamphlet for mastitis care should be created and provide it to patients and their family members to reduce the occurrence and recurrence.