照顧一位舌癌病人術後之護理經驗

Nursing Experience for a Post-operation Patient with Tongue Cancer

本文旨在敘述一位44歲中年男性，因舌頭鱗狀上皮細胞癌接受舌楔狀切除術及選擇性淋巴摘除術術後之護理經驗。護理期間自2016年10月22日至2016年10月29日，藉由會談、觀察、身體評估及病歷查閱方式收集資料，確立個案的主要護理問題為急性疼痛、口腔黏膜障礙及身體心像紊亂。護理過程中筆者透過主動關懷、陪伴及傾聽方式，建立良好的護病關係，針對個案的主要健康問題提供基本生理需求，並透過止痛藥物和輔助療法，如背部按摩、穴位按摩、音樂治療及芳香療法來緩解疼痛；加強個案術後口腔護理，改善口腔異味及降低感染風險；並藉由鼓勵個案表達內心感受、同理及接受個案負向情緒發洩，引導個案以正向態度參與自我照顧，重建正向自我概念，順利適應術後生活。期望藉此護理經驗能提供臨床護理同仁照護此類個案之參酌。 This article described the nurse experience for a forty-four-year male who suffered from tougue squamous cell carcinoma and underwent wedge glossectomy with selective lymphadenectomy. From October 22 to October 29, 2016, data were collected through interview, observations, physical examination, and chart review. The major health problems of patient were identified including acute pain, impaired oral mucous membrance, and disturbed body image. During the nursing process, the author established a good nursepatient relationship through active caring, companionship, and listening. Nursing interventions offered basic physical needs for patient´s health problems, pain relef using analgesics, complementary therapies such as back message, music theraphy, and aromatherapy. The author also strengthened oral hygiene post-operation to decrease oral odor and avoid infection risk; to encourage patient to express his internal feelings, empathized and accepted patient vented the negative mood, to guide patient to paticipate in self-care and rebuild in a positive self-concept, to help patient to adapt to life of post-operation smoothly. This paper is expected to share the care experience as a reference with nurses who care those patients in similar conditions.