照護一位初次罹患口腔癌個案之門診護理經驗

Nursing Experience of Outpatient Care of a Firsttime Oral Cancer Patient

本文描述照護一位初次罹患口腔癌個案，接受手術後歷經生理改變造成心理衝擊之門診護理經驗。護理期間為2019年10月9日至12月30日之門診回診期間，筆者透過訪談、觀察、身體評估、查閱病歷、電訪與使用通訊軟體傳遞訊息等方式收集資料，運用Gordon 11項健康功能評估，確立個案有口腔黏膜受損、言辭溝通障礙及身體心像紊亂等健康問題。護理期間提供個別性照護，得知個案有唱歌興趣，教導口腔復健運動搭配其喜愛的歌曲促進動機；運用同理心傾聽個案對身體外觀改變的感受，藉病友的經驗分享及家庭支持系統來勉勵個案，幫助個案接受術後身體心像改變之事實。建議未來可於門診設立頭頸部腫瘤諮詢室，與治療團隊溝通合作，結合社會資源，依個案需求提供醫療諮詢與協助，讓個案能獲得更專業之整合性照護。希望藉此護理經驗，提供護理同仁為照顧類似個案之參考。

This article recounts the experience of providing nursing care to a patient with oral cancer in an outpatient setting from October 9th to December 30th, 2019. Through a comprehensive data collection process, including interviews, observations, and medical records, the author identified key health issues, such as oral mucosa damage, impaired speech and communication, and disturbance of physical and mental body image, using Gordon's 11 health functions evaluation. To provide personalized care, the author incorporated the patient's interest in singing into their rehabilitation plan, teaching oral exercises set to their favorite songs to boost motivation, and used empathetic listening to address their concerns about body changes. Additionally, the author leveraged patient and family support systems to encourage acceptance of post-operative changes. Based on this experience, the author recommends establishing a dedicated head and neck cancer consultation room, collaborating with the treatment team, and integrating social resources to provide tailored care, with the goal of providing a reference for nursing colleagues caring for similar patients.