照護一位罹患卵黃囊腫瘤婦女之護理經驗

Nursing Experience of A Woman Suffering from Yolk Sac Tumor

本文旨在描述一位罹患卵黃囊腫瘤之婦女，住院接受減積手術，所造成的生理及心理衝擊之護理經驗。護理期間自2018年10月4日至2018年10月12日。照護期間運用整體性護理評估架構，確立個案有：「焦慮」、「急性疼痛」、「親職角色衝突」之健康問題。透過周全的手術前後照護，與個案建立良好護病關係、引導說出心中的擔憂、並協助其與醫療團隊溝通，以增加個案對疾病治療的控制感進而減輕焦慮；提供疼痛緩解的方法，如轉移注意力、避免傷口牽扯、背部肌肉按摩、評估疼痛之PQRST，並適時給予止痛劑使用；表達同理心並分享同為母親照顧經驗，提供親子依附之方式、鼓勵案夫探視並表達關愛及安排家庭會議以協助個案增加支持系統，進而減輕其親職角色衝突之壓力。盼藉此經驗能提供護理人員作為日後在照顧類似病患之參考。

This case report describes the experience of caring for a woman suffering from yolk sac tumor with debulking surgery. Through a comprehensive nursing assessment from October 04 to October 12, 2018, both physical and psychological impacts were revealed as following: anxiety, acute pain, and parental role conflict. A sophisticate pre-post operation nursing care was developed to increase the sense of control of surgery to reduce anxiety. The author built up a trust relationship with the patient, guided her expressing concerns about the surgery, and assisted the patient to communicate with the medical team. PQRST pain assessment, back massage, and attention distracting were utilized for pain relief. Analgesics was used when needed. The author shared mothering experience to express empathy, and arranged mother-infant attachment to reduce the stress of parental role conflict. Patient's husband was encouraged to show love while visit. Happy family meetings were delivered to enhance patient's support systems. The findings may be helpful as a reference in caring for women with similar experience.