協助一位人工膀胱病人面對手術之護理經驗

The Nursing Experience of Helping a Neobladder Patient

人工新膀胱手術是膀胱癌患者行膀胱切除最新的治療方式，病患接受膀胱切除後沒有造口，亦不須執行間歇性自我導尿，且能從尿道口自然的排尿。這種創新的手術帶給病患希望，同時也提高了生活品質。本篇主要是探討一位年僅歲膀胱癌病患接受人工新膀胱的護理經驗。病患在住院期間產生許多身、心、社會層面之護理問題，護理期間經由觀察、會談、傾聽及身體評估等方式，深入了解個案的需求與壓力。其主要的護理問題有焦慮、高危險性感染、身體心像紊亂及健康維護能力改變。經由提供個別性護理措施及整體性的照護，並鼓勵家庭成員參與協助，促進個案建立信心，增進對疾病的認知，勇於面對疾病的衝擊，使其重返原有的社會生活。將此護理經驗提出分享，以供護理人員照護的參考。

The Neobladder surgeon is the newest treatment of the patient with bladdercancer. There is no ostomy after Radical Cystoprostatectomy. The patient doesn'tneed to do self-catheterization periodically and can discharge urine through theurethra naturally. This creative surgery brings hope to the patients. It also improvespatients' living quality.This report is to study the nursing experience of a 35-year-old Neobladderpatient who took Neobladder surgery. In the process of nursing care, the nursesunderstood the patient's needs and pressures by means of observation, interviewing,listening, and physical assessment. The major patient's problems were anxiety,high-risk infection, psychosomatic confusion, and the changed health maintenanceability. By way of providing individual nursing treatment and total care and encouragingfamily members' participation, the patient was able to rebuild confidence andincrease knowledge of the disease. The patient was encouraged to face the impactof the disease and resume original social life.