一位接受性別重置手術個案之護理經驗

Nursing Experience of a Patient Undergoing Gender Reassignment Surgery

本文描述一位接受性別重置手術的個案護理經驗。該個案生理性別為男性，長期感到性別不安，經歷性別認同過程後，選擇接受性別重置手術，隨之出現生理和心理問題。護理期間為2023年6月6日至6月11日，通過身體評估、觀察、會談及查閱病歷等方式，運用Gordon十一項功能健康型態進行整體性評估，確定急性疼痛、焦慮及個人認同紊亂的三項健康問題。在護理過程中，針對個案提供個別化照護。透過數字疼痛量表評估，使用藥物及非藥物方法控制疼痛，並評估藥物反應，減輕個案疼痛；提供情緒支持、鼓勵表達內在感受及提供相關衛教資訊，提升個案對自身狀況的掌控感，緩解其焦慮；與個案、家屬及醫療團隊共同討論，建立良好的護病關係，尊重並同理個案的感受，緩解因內外在感受引起之個人認同紊亂的問題。希望此次護理經驗中對性別重置術後個案提供的疼痛管理、心理支持、及尊重與同理等照護措施，能為未來照護類似個案提供更全面和有效的參考。

This article describes the holistic nursing experience of a transgender woman who underwent gender reassignment surgery following a long-term journey with gender dysphoria, facing significant physical and psychological challenges post-surgery. During the acute care period from June 6 to June 11, 2023, data collected via Gordon’s 11 functional health patterns—through physical assessments, observations, interviews, and medical record reviews—identified three primary nursing diagnoses: acute pain, anxiety, and disturbed personal identity. Individualized interventions were implemented to address these issues, which included utilizing numeric pain scale assessments alongside both pharmacological and nonpharmacological techniques to closely monitor and alleviate wound discomfort, as well as providing tailored postoperative dietary and wound care education to reduce anxiety. To support the patient through identity disturbances stemming from internal and external perceptions, the care team emphasized an empathetic, respectful, and collaborative approach involving the patient and her family, successfully fostering a strong therapeutic relationship. Ultimately, this clinical experience highlights how integrating precise pain management with culturally competent, respectful psychological support can serve as a comprehensive and effective reference for healthcare providers optimizing care for individuals undergoing gender-affirming surgeries.