協助一位子宮頸癌患者於術後重建母親及妻子角色之護理經驗

The nursing care experience of assisting a woman who had cervical cancer treated with surgery to rebuild “the role of mother and wife”

本文為協助一位產後四個月正在哺乳的 39 歲婦女，因罹患子宮頸癌需行根除性子宮全切除手術，面臨哺乳中斷及性生活形態改變等之護理經驗。自2010 年10 月7 日至10 月22 日護理期間，以Gordon 十一項功能性健康評估為指引，經會談；觀察及電話訪問收集資料，發現個案依時間排序之健康問題為焦慮；母乳哺餵中斷及性生活形態改變。筆者為個案的專科護理師，照護期間與個案及案夫建立良好護病關係，除解決個案生理需求外，並協尋母乳捐贈者於個案無法擠乳期間供應母乳，滿足個案在手術期間能持續哺餵母乳之需求；在回診會談與持續性電話訪談，適時提供心理支持及性生活因應技巧，讓個案逐步適應子宮切除後之性生活，重拾身為女人之自信，分享此照護經驗，期為照護此類個案之參考。

This paper depicts the nursing care experience of assisting a 39-year-old four-month postpartum and breastfeeding woman, who faced radical hysterectomy and overcoming the consequences of breastfeeding interruption and the changes of sexual life. Gordon’s 11 Functional Health Patterns were used as a guide to assess health problems of the client through in person interviews, observations, and telephone interviews during the two-week period from October 7th to 22nd, 2010. Three health problems were identified chronologically: anxiety, interruption of breastfeeding, and changes of sexual life. The first author, the nurse practitioner of the client, had built up a good relationship with the client and her husband during the nursing care period. In addition to fulfilling the client’s physical needs, the nurse practitioner initiated breast milk donations for the client to continue breast-milk feeding during the entire surgical period and hospitalization. Further, to assist the client to adapt to an active sexual life after radical hysterectomy and rebuild her confidence of being a woman, the nurse practitioner provided mental support and educated the patient in skills to cope with the change in her sexual life during the outpatient department follow-up and telephone interviews. This nursing care experience could be a reference for nurses in providing care to similar cases.