改善直腸癌病人低前位切除術腸道功能障礙

To Improve Bowel Function among Rectal Cancer Patients with Low Anterior Resection

直腸癌病人接受低前位切除術導致排便型態紊亂，嚴重影響病人生活品質。本院直腸癌病人術後3個月，低前位切除術症候群評估量表（low anterior resection syndrome score）平均得分30.1分。分析原因為病人對低前位切除術症候群（low anterior resection syndrome, LARS）自我照護認知不足、個案管理護理師未接受相關課程與缺乏照護流程。專案目的為改善病人術後3個月LARS嚴重度，改善措施包括發展指導工具，並採用LINE官方帳號整合指導訊息、舉辦個案管理護理師LARS照護技能教育課程，及發展標準照護流程，包含物理治療轉介機制。專案實施後，病人術後3個月LARS平均分數改善至8.8分。建議未來將LARS照護跨單位推廣，提高直腸癌存活者的生活品質。

Low anterior resection for rectal cancer patients leads to disordered defecation patterns and significantly impacts their quality of life. Our hospital's rectal cancer patients scored a low anterior resection syndrome (LARS) score of 30.1 points three months after surgery. The reasons analyzed pertain to patients' inadequate awareness of LARS self-care, case management nurses' lack of relevant courses, and a deficiency in care processes. The aim of the project is to alleviate the intensity of LARS in patients three months after surgery. The improvement solutions included developing guidance tools and using LINE official accounts to integrate guidance messages. LARS care skills education courses were held for case management nurses. Additionally, standard care procedures were developed, including a physical therapy referral procedure. The project resulted in an average LARS score of 8.8 points for patients three months after surgery. To enhance the quality of life of rectal cancer survivors, it is suggested that LARS care be promoted across units in the future.