光碟護理指導與一對一護理指導正確性之比較－－以南部某醫學中心產婦坐姿母乳哺餵為例

Comparison of Correctness between Individual Teaching with and Without Video Demonstration of Maternal Breastfeeding in the Sitting Position: Experience of a Medical Center in Southern Taiwan

本研究目的探討初次罹患乳癌病人從發現、就醫至接受治療之求醫歷程。採質性研究深入訪談法，針對南部某醫學中心初次罹患乳癌之住院病人共35位為研究對象，依據半結構訪談大綱，進行一對一之訪談，每位病人訪談時間約40－60分鐘，訪談後立即將訪談內容謄寫成逐字稿，再將所得資料，藉用NVivo 9電腦軟體協助進行資料分析、歸類並命名。結果發現初次乳癌個案之求醫歷程分為四個階段，包括：一、難以相信：「害怕不安」、「悔不當初」及「拒絕接受」；二、矛盾衝突：「不確定疾病變化之變數」、「畏懼疾病治療」及「身體狀況異常之現象」；三、突破困境：「醫療守護我」、「親情扶持與陪伴」及「媒體資訊」；四、重拾生活：「勇於面對」及「接受事實」。期待藉由初次罹患乳癌之求醫歷程的分析結果，提供臨床護理人員在照顧這群病人時能協助其身心適應及儘早接受疾病及治療，進而提供他們所需要的照護，以促進疾病穩定及重回規律生活。

The purpose of this study was to examine the process of seeking medical treatment experienced by patients when they first discovered that they had cancer. The experience included visiting doctors and receiving treatment. The study employed qualitative research through in-depth interviews. A total of 35 patients who were newly diagnosed with breast cancer and were hospitalized in a medical center in Southern Taiwan were included in the study. One-on-one were conducted using a semi-structured interview guide. Each interview lasted for approximately 40 to 60 minutes. The interview content was transcribed verbatim immediately after each interview. NVivo9 computer software was then used to analyze, classify, and name the obtained data. The medical treatment process for initial breast cancer was divided into four stages. 1. Disbelief:' fear and unrest,' ' regret,' and' rejection.' 2. Conflict:'variables of uncertain changes in the disease,' ' fear of receiving treatment,' and 'abnormal physical condition.' 3. Overcoming a dilemma:' medical treatment is guarding me,' 'family support and companionship,' and 'media information.' 4. Regaining life quality:'courage to face reality' and 'accepting the fact.' By analyzing the results of the medical treatment for patients who were newly diagnosed with breast cancer, the data may assist clinical nurses in helping such patients to adapt physically and psychologically and to accept their disease and receive treatment as soon as possible. Nurses can further provide the care that the patients require, thereby promoting the stability of the disease and the patients' return to a regular life.