一位指關節罹患骨巨細胞瘤年輕女性術後之照護經驗

本文敘述一位右手小拇指關節罹患骨巨細胞瘤接受手術治療年輕女性，護理期間自2020年2月3日至2月10日，經由會談、身體評估、觀察及直接照護等方式收集資料，運用Gordon十一項健康功能型態評估進行整體性評估及資料整合分析歸納，確立個案有知識缺失、急性疼痛及焦慮等健康問題。護理過程依個別性及認知程度提供診療計畫及術後相關衛教資訊，透過多媒體影音教學及圖片資訊，增強其傷口照護認知技能及定期就醫之重要性；評估傷口急性疼痛採定時投與止痛藥及薰衣草精油按摩雙管齊下，以減緩其疼痛不適；運用醫病共享決策瞭解其內心想法及澄清其疑慮，減輕對腫瘤切除預後之恐慌不安，透過良好治療性護病關係及重要親友陪伴支持，使其抒發焦慮不安情緒，鼓勵正向心態適應其疾病變化，期望經由此護理經驗分享，以供臨床實務參考之用。

This paper describes the nursing care of a young female patient who underwent surgery for a giant cell tumor of the bone on the right little finger joint. The nursing period was from February 3, 2020, to February 10, 2020. Data were collected through interviews, physical examinations, observations, and direct care. Gordon’s 11 functional health patterns were used for comprehensive evaluation, data analysis, and compilation, confirming that the patient experienced a lack of knowledge, acute pain, and anxiety. During the nursing process, a personalized treatment plan and postoperative health education were provided based on the patient’s level of awareness. Multimedia video education and images were used to teach the patient wound care techniques and emphasize the importance of periodic follow-up after discharge. For managing her acute wound pain, analgesics were administered regularly, and lavender essential oil massage was used as an additional pain relief method. Shared decision-making was employed to understand the patient’s thoughts and address her concerns, helping to alleviate her fear and discomfort following the tumor resection. A strong therapeutic relationship was established between the nurse and the patient, as well as her close relatives and friends, to help her express her anxiety and discomfort. The patient was encouraged to maintain a positive attitude to adapt to the changes during her disease course. We hope that sharing this nursing experience will provide a valuable reference for clinical practice.