一位潰瘍性結腸炎接受哈特曼手術個案之手術全期護理經驗

A Perioperative Nursing Experience of an Ulcerative Colitis Patient Undergoing Hartmann's Operation

本文探討一位潰瘍性結腸炎接受哈特曼手術個案之手術全期護理經驗。照顧期間自2019年3月6日至3月7日，筆者以觀察、會談、身體評估及病歷查閱等方式收集資料，並運用手術全期護理模式進行整體性健康評估，確立個案之健康問題有：焦慮、潛在危險性手術情境傷害及身體心像紊亂。筆者於手術前訪視，告知手術全期過程，以緩解個案焦慮；透過姿勢擺位、預防異物存留以維護安全，使個案免於潛在危險性手術情境傷害；經給予心理支持、引導正向看法，使個案接受腸造口的存在。期望此護理經驗能提供日後照顧此類病人參考。

The purpose of this article was to describe a perioperative nursing experience of an ulcerative colitis patient undergoing Hartmann's operation. From March 6 to March 7, 2019, data were collected through observation, interview, physical assessment, and chart review. The perioperative nursing model was applied to assess patient's overall health. The health problems identified included anxiety, potential risk of surgical situation injury, and body image disturbance. At preoperative visiting the author informed the patient of the perioperative process to relieve his anxiety. Posturing position was to prevent the patient from inadvertent retention of foreign material, and maintain safety for avoiding the potential risk of surgical situation injury. Providing mental support and guiding positive viewpoint made the patient accept the existing intestinal stoma. Hopefully, this nursing experience can serve as a reference for caring the similar patients.