一位腸造口病患的心理社會問題與適應行為

Psychosocial Problem and Coping Behavior of A Patient with Colostomy

本探討一位需接受永久性腸造口之中年女性患者的心理社會問題與適應行為，在住院期間，個案面臨永久腸告有害怕、失落、身體心像改變與社交互動障礙之心理社會問題，依據Lazarus & Folkman理論協助個案調整情緒，並增強以問題為取向之適應行為，護理人員除提供個案生理照顧外，還扮演支持者、諮詢者與傾訴者的角色，引導其訴說所害怕及擔心的事，提供正確的造品觀念，協助個案面對問題、尋求協助、熟悉新技能以墜進自我控制，因個案有好的人格特質，及藉由成功個案與家庭成員良好的互動之下，使個案能逐漸調適腸造口所帶來之身心衝擊。

The purpose of this study was to discuss the psychosocial problem and coping behavior of a middle aged female patient who received a permanent colostomy. During hospitalization, we found that the patient showed fear, loss, body image change and isolation from society of psychosocial problems. According to Lazarus and Folkman theory we helped the patient adjust her emotion and deal with her problem-oriented behavior. The primary nurse not only provided physical care, but also she played the role of a supporter, communicator and listener. The nurse would lead the patient to open up her fear and worry, providing her with the right concept about colostomy. She helped the patient face the problem, ask for help, become familiar with new techniques and improve self-control. The patient's good personality in conjunction with better interaction with family members will help her adjust to the physical and psychological impact from the colostomy.