一位年輕男性口腔癌術後個案面臨身體心像改變之護理經驗

The Nursing Experience of Caring for a Patient with Body Image Disturbance

本篇敘述一位未婚男性罹患口腔癌，接受廣泛性腫瘤切除及左手前臂皮瓣重建手術所面臨身、心衝擊之照護經驗。於2014年3月15日至3月28日，運用觀察、會談、身體評估及查閱病歷等方式收集資料，歸納分析個案有疼痛、口腔黏膜障礙、身體心像改變及無望感的健康問題。藉由積極陪伴，與個案建立信任的護病關係，提供適切的照護及緩解疼痛方法；執行口腔清潔以預防感染發生；引導其表達外觀及功能改變之內心感受，使其能接受身體外觀、結構及功能的改變；個案僅36歲即罹患口腔癌，帶給自己及家屬極大的震憾及無望，評估其無望感的來源，並透過與其女友聯絡溝通，重建新的親密關係，適時給予正向心理支持與鼓勵，使其能肯定自我生命價值。期盼藉此照顧經驗的分享，提供照護此類病人之參考。

This article describes the nursing experience of caring for a 36-year-old unmarried male suffering from body image disturbance secondary to radical oral surgery and reconstruction. From March 15 to 28, 2014, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: pain, impaired oral mucous membrane, disturbed body image, and hopelessness. During the nursing period, through attentive company and a good nurse-patient relationship, the patient was provided adequate care for pain relief. The patient was taught to maintain good oral hygiene to prevent infection. Through expression of internal feelings, the patient could accept the changes in oral appearance, structure, and function. The patient felt shocked and hopeless when he was diagnosed with oral cancer. The patient rebuilt a new close relationship with his girlfriend and received her support and encouragement and further reconfirmed his self-worth in life. The author expects that this care experience can serve as a reference for those caring for patients in similar cases.