下咽癌接受全喉切除術個案之照護經驗

Nursing Experience of a Patient with Hypopharyngeal Cancer Undergone Total Laryngectomy

本篇個案報告係探討一位49歲初次罹患下咽癌的男性個案面臨疾病與手術衝擊之護理經驗。筆者照護期間自93年10月17日至93年11月8日，運用Gordon十一項功能性健康型態為評估工具，以會談、觀察、身體評估等方式，收集主、客觀資料，確認個案有焦慮、身體心像紊亂、言辭溝通障礙等護理問題，針對個案問題擬定個別性護理計畫，協助減輕個案面對手術及疾病的焦慮；經常主動關懷，引導個案表達內心感受，並介紹成功全喉切除個案及無喉復聲協會義工訪視，以過來人身份予以開導，替個案加油、打氣，讓個案發現自己並不孤單並增強個案自信心，最後個案勇敢面對及學習如何自我照顧；並適時提供溝通技巧，例如「溝通卡」的使用，協助個案適應全喉切除之情形；並教導家屬參與照護，使個案在治療過程中，獲得最佳身、心、社會的適應。

The purpose of this case report was to discuss a 49-year-old man with hypopharyngeal cancer,who experienced the shock of the illness and surgical intervention. The author collected his informationaccording to Gordon 11 functional health model assessment tool, through conversation,observation, and physical assessment during from October 17th to November 8th, 2004. To determiningpatient's anxiety, pain, mental confusion, communication and problems. The author focusedon making individual nursing plans for the patient. Assisting the patient to manage surgery anddisease and anxiety relieve patients pain. She showed concerns to the patient and guidence toexpress his feeling. Introducing previous patients volunteers and encourage him, strong his confidenceand help him to realize that he is not alone. During the treatment, and guidence, the authoralso educated the patient's family how to participate in taking care of him. Finally this patient wasable of facing his condition bravely, knowing how to take care of himself and physically, mentallyand socially.