舌癌手術病人之照護經驗

Perioperative Nursing Experience of a Tongue Cancer Patient

本文探討一位舌癌患者接受手術治療的護理經驗。照護期間自92年2月24日至92年3月6日，筆者運用Gordon十一項功能性健康型態進行評估，發現患者主要有：焦慮、急性疼痛、口腔黏膜改變、身體心像改變等健康問題。護理過程中，除了協助患者面對身體的不適外，其中疾病與治療產生的心理障礙，也連係著患者的整體預後與調適。針對患者自覺會成為家人負擔而掩飾自我感受，筆者以主動關懷和傾聽方式，與患者及家屬建立良好治療性護病關係後，進而讓患者學到自我照護技巧，確實執行口腔清潔以預防傷口發生感染，增加其術後之信心及正向觀，由於患者年歲已高記性不佳，故在護理指導時也注重家屬的參與及學習照護。期藉此經驗，提供護理同仁照護此類患者之參考。

This article is to present the nursing experience of a tongue cancer patient. The nursing care period ranged from February 24 to March 6,2003. The nurse used the Functional Health Patterns, and discovered the patient's main health questions included: anxiety, acute pain, oral cavity mucous membrane change, and body image change. In the process, the patient's body image and psychological disturbance were correlated with the prognosis. The patient feared in his own situation to become a burden to family members and may try to conceal real emotion. The nurse showed loving care and listened attentively to the patient to establish good relations with him. Goals included enabling to enable the patient to learn the good skills for selfcare, truly to carry out good oral hygiene to prevent infection in the wound and to help increase patient's post-surgery confidence and positive thinking. Because the patient was old and his memory not good, the nurse payed great attention and encouraged the patient's family participation and also learning how to care for the patient. By sharing this experience, nurses can use the article as a resource and gain insight into caring for similar patients in the future.