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題名:照護一位口腔癌復發併惡性蕈狀傷口病患面對死亡之護理經驗
書刊名:長庚護理
作者:賴玟均李佳玲
作者(外文):Lai, Wen-chunLi, Chia-ling
出版日期:2018
卷期:29:2=102
頁次:頁260-271
主題關鍵詞:惡性蕈狀傷口慢性疼痛死亡焦慮Malignant fungating woundChronic painDeath anxiety
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
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  • 共同引用共同引用:18
  • 點閱點閱:5
本文乃探討一位口腔癌末期個案因惡性蕈狀傷口導致疼痛、惡臭及外觀改變,又因疾病末期面臨到無法預測疾病過程進而產生死亡焦慮之護理經驗,護理期間自於2016年1月15日至2月23日,運用Gordon十一項功能性健康型態評估,及藉由觀察、傾聽、會談等方式收集個案之相關資料,確認個案有「慢性疼痛」、「組織完整性受損」、「身體心像紊亂」及「死亡焦慮」等四個護理問題。在照護過程中,以個案為中心,提供病患及家屬提供完整性照護,緩解個案生理、心理之不適症狀,共同擬定照護計畫,並提供個別性之護理措施,轉移對疼痛的注意力,調整換藥處置,適時鼓勵並接受負向情緒的表達,且整合醫療團隊,運用安寧療護理念,與個案建立良好護病關係,引導個案說出外觀及功能改變的內心感受,提供隱密的環境,主動關懷及傾聽,最後在家屬陪伴之下完成個案後事安排,以達到生命末期之照護,期待透過此照護經驗之分享,提供臨床醫療團隊照護生命末期個案之五全照護之參酌。
This article described nursing process of caring a patient with terminal oral cancer with pain, malodor, and appearance changes caused by malignant fungating wound. The patient also experienced anxiety because of the unpredictable disease progress and facing the fear of death. During the nursing period from 1/15/2016 to 2/23/2016, the author used Gordon's 11 Functional Health Patterns Assessment as the assessment tool, and used other methods, such as interviews and observations, to collect relevant data of the patient. The established main nursing problems were: chronic pain, impaired tissue integrity, body image disturbance, and death anxiety. During the nursing process, the author used tranquility care philosophy and established a good relationship with the patient, actively caring and listening and providing individual care and timely encouraging and accepting the expression of negative emotions. Patient-centered cares were arranged and provided by the integrated medical team. The author also provided support to patient and his family members to alleviate the physical and psychological symptoms and finally achieve the end of life care. This nursing experience provides a reference for caring similar patients.
期刊論文
1.李雅萍、黃馨葆、蔡兆勳、陳慶餘、邱泰源(20120300)。癌症疼痛控制的現況。安寧療護,17(1),62-75。new window  延伸查詢new window
2.簡慧琪(20100400)。運用靈性照護於一位肝癌末期病人之護理經驗。護理雜誌,57(2附冊),47-52。new window  延伸查詢new window
3.魏嘉儀、許美玉(20120200)。一位乳房惡性蕈狀傷口個案初次接受治療之護理經驗。志為護理,11(1),109-118。  延伸查詢new window
4.謝孟娜(2012)。運用護理指導技巧增進一位壞死性筋膜炎患者傷口照護能力之護理經驗。領導護理,13(4),70-80。  延伸查詢new window
5.江怡嫻、姚靜宜、邱燕甘(20111200)。運用安寧緩和療護照顧一位口腔癌末期病人之護理經驗。腫瘤護理雜誌,11(2),75-86。  延伸查詢new window
6.林雅婷、陳素月(20150400)。照顧一位惡性腫瘤蕈狀傷口病患之護理經驗。高雄護理雜誌,32(1),53-66。  延伸查詢new window
7.吳曉玟、謝春金(20140200)。一位肝癌末期個案面臨死亡焦慮之護理經驗。志為護理,13(1),90-100。  延伸查詢new window
8.尹加慧、潘玉玲(20150300)。照顧一位乳癌婦女惡性蕈狀傷口之照護經驗。源遠護理,9(1),80-86。  延伸查詢new window
9.蔡雅雯、莊情惠(20120600)。照護一位舌癌復發合併傷口惡化的病人之護理經驗。長庚護理,23(2)=78,247-255。new window  延伸查詢new window
10.陳怡文、蘇秋萍、周莉莉(20110200)。照顧一位肝細胞癌合併骨轉移病患之護理經驗。志為護理,10(1),110-119。  延伸查詢new window
11.許淑婷、施秀鈴、潘雪幸(20151200)。照顧一位口腔癌末期病人之安寧善終療護經驗。腫瘤護理雜誌,15(2),83-94。  延伸查詢new window
12.高美華(20110100)。慢性疼痛之概念分析。馬偕護理雜誌,5(1),7-14。  延伸查詢new window
13.Przezdziecki, A.、Sherman, K. A.、Baillie, A.、Taylor, A.、Foley, E.、Stalgis-Bilinski, K.(2013)。My changed body breast cancer body image distress and self-compassion。Psycho Oncology,22(8),1872-1879。  new window
14.Albi-Feldzer, A.、Mouret-Fourme, E. E.、Hamouda, S.、Motamed, C.、Dubois, P. Y.、Jouanneau, L.、Jayr, C.(2013)。A double-blind randomized trial of wound and intercostal space infiltration with ropivacaine during breast cancer surgery: effects on chronic postoperative pain。Anesthesiology,118(2),318-326。  new window
15.Hicks, D.、Cummings, T.、Epstein, S. A.(2010)。An approach to the patient with anxiety。The Medical Clinics of North America,94(6),1127-1139。  new window
16.Probst, S.、Arber, A.、Faithfull, S.(2013)。Malignant fungating wounds: the meaning of living in an unbounded body。European Journal of Oncology Nursing,17(1),38-45。  new window
其他
1.衛生福利部統計處(2015)。主要死因分析,http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=5 012.。  new window
 
 
 
 
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