協助一位初次罹患直腸癌病人學習自我照護腸造廔口之護理經驗

Nursing Experience of a Patient with Newly Diagnosed Rectal Cancer Learning Self-Care of Colostomy

本文描述一位中年男性初次罹患直腸癌，接受腫瘤切除及腸造廔口成形術學習自我照護腸造廔口之經驗。護理期間為2017年4月21日至4月23日，運用生理、心理、社會、靈性評估模式進行整體性資料收集與分析，確立問題有知識缺失、情境性低自尊、潛在危險性感染。透過文獻探討，衛教手術後預防感染知識與飲食攝取；分享成功案例引導正向自我肯定，使個案接受罹病事實，激勵照護腸造口學習動機。配合個案使用智慧型手機習慣，創新以手機錄製更換造廔口之影片與回覆示教方式，讓其學會照護知識與技巧，達最終自我照護目標。

This article describes the experience of learning self-care by a male patient newly diagnosed with rectal cancer who received tumor resection surgery and colostomy. The nursing period spanned from April 21st, 2017 to April 23rd, 2017. We conducted holistic data collection and analysis using a physiological, psychological, social, and spiritual assessment model. The analysis revealed the following health-related issues: knowledge deficit, situational low self-esteem, and a potential risk of infection. A literature review provided relevant knowledge for the prevention of postsurgery infections and diet. Successful cases motivated the patient toward positive self-approval and negative emotion release. Additionally, the patient was inspired to accept his illness and to learn about postsurgical self-care. The changes in the fistula pouch were recorded and combined with progressive reply teaching on a cell phone, enabling the patient to acquire care-related knowledge and skills. The ultimate goal of self-care was attained.