照護一位舌癌復發合併傷口惡化的病人之護理經驗

Nursing Experience of Caring for a Recurrent Tongue Cancer Patient with Wounds

本篇個案在探討一位舌癌復發合併傷口惡化再度入院之個案，因面對舌癌復發及手術治療後其傷口仍持續惡化，引發個案身、心問題。護理期間從2009年5月28日至2009年7月20日，筆者經會談、觀察並運用Gordon十一項健康功能型態進行評估，確立個案有疼痛、口腔黏膜障礙、身體心像紊亂及預期性哀傷等問題，透過傾聽、關懷、同理與接納之護理方式，指導個案傷口照護技巧、增加其口腔清潔舒適與緩解傷口惡化造成的疼痛，鼓勵個案以正向態度接受自我及面對身體結構改變事實，使其面對舌癌復發時能克服因傷口惡化所帶來的衝擊。經由護理此個案，深刻體會護理人員在照護時，唯有適切地給予個別性及整體性的護理指導，深入了解其所面臨的身心問題，方能發揮護理獨特性功能。

This case report described the nursing experience of caring for a recurrent tongue cancer patient with wounds. The patient was hospitalized due to wounds that caused significant physical and psychological problems. The author assessed the patient by clinical observations, interviews, data collections, and the eleven-item Gordon Functional Health Measure during the caring period (May 28, 2009 ~ July 20, 2009). The patient was diagnosed suffering from some problems, such as pain, impaired oral mucous membrane, body image disturbance, and anticipatory grief. Nursing skills including listening, care, empathy, and acceptance were utilized. The author used some nursing information and interventions to help the patient overcome the mental discomfort, to improve skills in wound care to improve oral hygiene, to alleviate the pain caused by wounds, to encourage the patient accept the change in his body image, and to assist him in overcoming the impacts caused by wounds while facing recurrent tongue cancer. By means of this case report, the author realized deeply that by providing individual and complete nursing care, nurses can greatly improve the quality of care.