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題名:照護一位口腔癌病人手術後期間之護理經驗
書刊名:長庚護理
作者:林智敏陳昕霓
作者(外文):Lin, Chih-minChen, Hsin-ni
出版日期:2016
卷期:27:1=93
頁次:頁122-131
主題關鍵詞:口腔癌皮瓣手術口腔黏膜改變身體心像紊亂Oral cavity cancerFlap reconstructionOral mucosal changesBody image disturbance
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:29
  • 點閱點閱:49
本文運用羅氏適應模式,經由直接照護、會談和觀察,確立個案有口腔黏膜改變、疼痛、身體心像紊亂健康問題。個案因手術治療,造成口腔黏膜破壞,護理過程中生理方面,運用口腔黏膜照護指引,規則與個案共同執行口腔清潔護理,增進口腔黏膜傷口癒合、降低異味產生;以視覺類比量表為疼痛評估工具,並依據WHO的癌症疼痛緩解三階梯原則,與醫療團隊討論調整止痛藥物、利用轉移注意力和按摩技巧,有效緩解疼痛不適;心理方面,引導家人陪伴,引發個案與病友分享口腔癌腫瘤切除和皮瓣移植重建術癒後調適,護理人員主動關懷,幫助個案調適顏面改變的心理衝擊,並適應術後身體變化歷程,進而達到生、心理最佳適應狀態,回歸原本的社會生活。藉本文護理經驗分享,提升日後護理同仁照護此類個案之參考。
The Roy’s adaptation model was used to assess nursing problem through direct care, interview, and observation. The nursing problems being identified included oral mucosa change, pain, and body image disturbance. During the period of care, for oral mucosa change caused by surgery, by applying oral mucosal care guideline, we helped perform oral cleaning and care regularly to improve oral mucosal healing and decrease odour. We used the Visual Analogue Scale assess the pain. By following the WHO three steps analgesic ladder, we discussed with the medical team to modify analgesics and used attention diversion and massage to effectively alleviate pain and discomfort. In psychological aspect, we requested family members to accompany the patient, encouraged the patient sharing experiences of tumor resection and flap reconstruction with others patients, and provided active caring to help the patient adjust for psychological impact and physical change to improve physical and psychological well-being so that the patient can return to social life normally. This experience provided nurses with a reference for caring similar patients in the future.
期刊論文
1.Fingeret, M. C.、Vidrine, D. J.、Reece, G. P.、Gillenwater, A. M.、Gritz, E. R.(2010)。Multidimensional analysis of body image concerns among newly diagnosed patients with oral cavity cancer。Head & Neck,32(3),301-309。  new window
2.胡文郁、陳宛榆、羅淑芬、陳書毓、黃翰心、陳幼貴(20111200)。成人癌症疼痛臨床照護指引。腫瘤護理雜誌,11(增刊),87-127。  延伸查詢new window
3.李淑芳、李月珠、梁蕙芳(20100600)。提升化學治療合併放射線療法之口腔癌患者口腔護理指導執行率。長庚護理,21(2)=70,185-196。new window  延伸查詢new window
4.林翠姬、厲佩如、廖玉美、林采蓉(20130300)。照顧一位口腔癌接受口顎皮瓣重建手術之加護經驗。長庚護理,24(1)=81,90-98。new window  延伸查詢new window
5.蘇莉婷、劉倖吟、相青琪(20111200)。照顧一位罹患口腔癌患者之護理經驗。腫瘤護理雜誌,11(2),49-62。  延伸查詢new window
6.王宏銘、廖俊達、范綱行、吳樹鏗、詹勝傑、閻紫宸(2009)。頭部鱗狀細胞癌治療的新進展。腫瘤護理雜誌,9(8),51-67。  延伸查詢new window
7.王昭凌、李佳倫(2013)。一位口腔癌接受氣管切開術病人的照護經驗。馬偕護理雜誌,7(1),83-93。  延伸查詢new window
8.陳靜怡、黃惠玲、莊情惠(20100300)。一位口腔癌接受重建手術後有自殺意念病患之護理經驗。長庚護理,21(1)=69,109-117。new window  延伸查詢new window
9.崔宛玉、林寬佳、黃惠璣(20130600)。口腔癌手術病人於住院期間身體心像改變及其因應行為探討。護理暨健康照護研究,9(2),127-138。new window  延伸查詢new window
10.Ma, L. C.(2010)。Oral care considerations during the patient's cancer treatment。Oncology Nurse Advisor,8,24-28。  new window
11.張瓈方、張乃文、王桂芸(20100300)。身體心像紊亂之概念分析。長庚護理,21(1)=69,25-32。new window  延伸查詢new window
研究報告
1.衛生福利部統計處(2014)。101年死因統計結果分析。  延伸查詢new window
圖書
1.Schilder, P.(1950)。The image and appearance of human body。New York:International University Press。  new window
其他
1.World Health Organization(2011)。WHO's pain ladder,http://www.who.int/cancer/palliative/painladder/en/。  new window
 
 
 
 
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