照顧一位因肝惡性血管內皮瘤接受活體肝臟移植術後之護理經驗

Nursing Experience of a Patient with Hepatic Epitheloid Hemangioendotheliom Having Living Donor Liver Transplantation

本文探討一位因肝惡性血管內皮瘤接受活體肝臟移植術後之護理經驗，照護期間為2016年4月14至2016無5月9日，運用羅氏護理適應模式評估分析，藉由實際照護、身體評估及會談收集資料，確立個案有：急性疼痛、焦慮及知識缺失等護理問題，筆者運用同理心、傾聽及主動關懷等技巧，藉由醫護團隊的合作，提供個案連續性的照護與適切的護理指導。照護期間筆者協助個案減輕肝臟移植術後傷口的疼痛不適，進而鼓勵營養攝取，維持良好生理機能，也因移植術後，心理產生對健康恢復不確定感及焦慮，甚至對捐贈者的憂心及負罪感，筆者運用傾聽方式鼓勵說出內心感受，藉由家人陪伴支持，互相鼓勵，以實際行動面對新的人生，建立正確的思考模式，促進個案自我調適及導向正向的情緒反應；最後提供術後注意事項及出院後自我照顧有正確的認知，提升個案返家後之生活品質，藉此照護經驗作為往後臨床工作的參考。

The article described a nursing experience of a patient with Hepatic Epitheloid Hemangioendo-theliom having living donor liver transplanta-tion Caring period was from 14th April 2016 to 9th May 2016. Evaluating the patient with Ray's adaptation model, nursing study and communication, the author confirmed major issues including acute pain, anxiety and deficiency of knowledge. The medical team sympatheti-cally listened, nursed and provided continuous caring and optimal direction. The author assisted the patient in easing the pain of surgery wound, encouraged to have enough nutrients to maintain physiological function, then after the surgery, the patient might be fulled of anxiety and uncertainty, even felt guilty and worried about the donator. The family's support, encour-agement are essentially required to help the patient face the new life and establish optimistic viewpoint. Finally provided attention for self-care to improve the quality of life after discharge. This experience was as a reference for clinical work.