運用芳香療法於口腔癌術後個案之護理經驗

Nursing Experience from Application of Aromatherapy to an Oral Cancer Patient after Operation

口腔癌是台灣地區最常見的頭頸部惡性腫瘤，現顯微重建手術為最主要及根治性的治療方式。患者除了承受術後生理疼痛外，還需面臨手術造成顏面改變所引起的心理認同困境。本文敘述一位口腔癌復發行下頜骨重建手術之個案，護理期間為2012年2月19日至2012年3月3日，運用身體評估、觀察及筆談方式，以Gordon十一項功能性健康型態為評估工具收集資料，確立個案有疼痛、睡眠型態紊亂、身體心像紊亂之護理問題。筆者提供生理照護外，另使用輔助療法－－芳香治療在個案的護理措施中，藉由按摩、吸嗅、溫水沐浴方式，發揮香氛作用於腦內，引導個案正向情緒，改善憂鬱，達到舒壓止痛助眠效果。此外運用傾聽、陪伴、教導等護理技巧，提供相關衛教，鼓勵個案及家屬參與護理活動，減輕其生理及心理的不適感，協助個案接受自我身體心像改變，勇於面對自我，達到身心靈的改善。

Oral cancer is the most common cancer of the head and neck in Taiwan. Reconstructive surgery is the main treatment. In addition to physical pains after the operation, patients also face difficulty in psychological identity due to changes in the face. This article describes a patient who had reconstructive surgery of the mandible. The nursing period was between February 19th and March 3rd, 2012. Through physical assessment, observation, and conversation, and with Gordon’s 11-itemed Functional Health Patterns serving as the assessment method, the patient was found to have problems with physical pain, sleep pattern disturbance, and body image disturbance. In addition to physical nursing, the author also utilized complementary therapy, aromatherapy, with the patient. Massage, sniffing, and warm water baths were used to facilitate the effect of aroma on the brain, leading the patient towards more positive emotions and reducing depression; moreover, the aroma played a role in relieving pressure, killing pain, and aiding sleep. Nursing skills such as listening, companionship, and coaching were used, and education about hygiene was provided to the patient. The patient and the family were encouraged to participate in nursing care in order to reduce his physical and mental discomfort, assist him in accepting the change in body image and facing himself, and improve his physical, mental, and spiritual well-being.