照顧一位護理人員罹患乳癌行立即性腹直肌重建之護理經驗

Nursing Experience of A Nurse with Breast Cancer Undergoing Mastectomy and Immediate Reconstruction Surgery

本文描述一位護理人員，初為人母，意外發現罹患乳癌，行根除性乳房切除併立即性腹直肌重建手術，護理期間為2021年5月7日至2021年5月15日，藉由觀察、會談及直接臨床照護進行資料蒐集，運用Gordon十一項健康功能型態評估工具分析，確立個案有急性疼痛、身體心像紊亂及角色扮演失常之護理問題。筆者於照護期間適時給予止痛藥物及提供非藥物緩解疼痛技巧，改善生理之不適，與個案建立良好護病關係，並運用醫療團隊及社會資源，提供正確且個別性的衛教指導，使個案能正視及接納重建後身體的改變，勇於分享自身經驗，並藉由關懷及同理心，引導個案對於角色改變之想法，重塑自我角色，鼓勵家庭成員共同參與照護，協助認識生病後角色功能的改變，給予個案正向支持，以達到身心靈之健康，希望藉由此經驗可做為日後相關疾病照護之參考。

This article aims to describe the nursing experience of a nursing professional who becomes a mother for the first time but unexpectedly discovers she has breast cancer. She underwent a radical mastectomy followed by immediate pedicle transverse rectus abdominis flap reconstruction surgery. The nursing period was from May 7th to May 15th, 2021, and data were collected through observation, interviews, and direct clinical care. Based on the Gordon 11 Health Pattern Assessment tool, several nursing problems, such as acute pain, body image disturbance, and role dysfunction, were identified.
To address the aforementioned nursing problems, the author provided pain relief medication and non-pharmacological pain relief techniques to alleviate physical discomfort, as well as establishing a supportive nurse-patient relationship. The cooperation of the medical team and social resources was also utilized to provide accurate and individualized health education instructions, enabling the patient to face the physical changes following reconstruction and encouraging her to share her experiences with others. Furthermore, by providing care and empathy, the patient was guided in accepting role changes, reshaping self-identity, and involving family members during the nursing period. These strategies could assist the patient in acknowledging the changes in role function after illness and promoting both physical and mental health. This study could serve as a reference for the care of related illnesses in the future.