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題名:一位乳癌切除後執行乳房重建之手術全期護理經驗
書刊名:長庚護理
作者:涂碧娟吳金枝吳素蘭李夢英賀倫惠黃品慈
作者(外文):Tu, Bi-juanWu, Chin-chihWu, Su-lanLi Meng-ying,He, Lun-huiHuang, Pin-tzu
出版日期:2016
卷期:27:2=94
頁次:頁274-284
主題關鍵詞:乳房重建手術手術全期護理乳癌Breast reconstructionPerioperative nursing careBreast cancer
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)
  • 排除自我引用排除自我引用:0
  • 共同引用共同引用:17
  • 點閱點閱:47
本文描述一位43 歲女性已切除乳房四年,入院行乳房重建手術全期之護理經驗,護理期間為2013 年5 月1 日至5 月3 日,藉由觀察及訪談技巧並依據手術全期護理架構為指引,進行整體性評估後,確立病人的護理問題為:焦慮/ 與手術過程及未知的結果;潛在危險性手術情境傷害/ 與麻醉制動姿勢擺位、器材殘留、使用電燒筆;危險性體溫過低/ 麻醉及身體大範圍長時間暴露於空氣中及未加溫靜脈輸液有關。筆者在照護過程中,運用同理心建立良好的護病關係,於手術前訪視給予支持與鼓勵,並詳細說明乳房重建手術流程及相關照護,增加病人對手術的認知,減輕焦慮不安情緒;手術中期維持舒適安全的手術環境,正確計數各項器械、敷料,以預防潛在危險性傷害,減少不必要暴露及適度的保暖,穩定病人體溫於正常範圍,以利手術過程順利,降低合併症的產生。藉此護理經驗的分享,提供手術護理人員照護此類病人參考。
A 43-year-old female patient having a mastectomy for 4 years was admitted from the 1st to the 3rd of May in 2013. The authors conducted an overall assessment via observation and interview strategies according to the guidelines of perioperative nursing care. They then established the patient’s potential health problems, including (1) anxiety/with the surgical procedures and the unknown operative outcomes related; (2) potential harm from the surgery/anesthesia supine position retained; electrocautery knife related; and (3) hypothermia/general anesthesia and not warmed; intravenous fluids related. The authors established a good nurse-patient relationship holding in an empathy manner during this caring period. Before the operation, they supported and encouraged the patient. They also explained the details of the surgery and the post-operation care plans. These improved the patient’s knowledge of the surgery and alleviated her anxiety. Throughout the operation, via maintaining a safe and comfortable environment, complying with all safety protocols, as well as monitoring constantly the patient, they reduced the possibility of complications the patient might have. By sharing this nursing care experience, the report provides a reference for taking care other patients with a similar situation in the future.
期刊論文
1.陳俞婷、陳淑卿、吳淑貞(20091200)。一位乳癌接受乳房重建病患手術後之護理經驗。腫瘤護理雜誌,9(2),61-73。  延伸查詢new window
2.謝瑞嫻、黃瑞珍(20100600)。照護一位全髖關節置換術個案之手術全期護理經驗。長庚護理,21(2)=70,197-205。new window  延伸查詢new window
3.King, M. T.、Kenny, P.、Shiell, A.、Hall, J.、Boyages, J.(2000)。Quality of life three months and one year after first treatment for early stage breast cancer: Influence of treatment and patient characteristics。Quality of Life Research,9(7),789-800。  new window
4.Guo, P.、East, L.、Arthur, A.(2012)。A preoperative education intervention to reduce anxiety and improve recovery among Chinese cardiac patients: A randomized controlled trial。International Journal of Nursing Studies,49(2),129-137。  new window
5.趙明玲、林雅慧、鄭如玉、林嘉玲、邢鴻君、余秋霖(20090300)。手術衛教介入對改善脊椎手術病人焦慮之成效探討。輔仁醫學期刊,7(1),29-38。  延伸查詢new window
6.Hu, E.、Alderman, A. K.(2007)。Breast Reconstruction。Surgical Clinics of North America,87(2),453-467。  new window
7.Weaver, C.(2009)。Caring for a patient after mastectomy。Nursing,39(5),44-48。  new window
8.林怡伶、趙莉芬、王昭慧(20140600)。協助一位乳癌婦女面臨乳房重建失敗之護理經驗。長庚護理,25(2)=86,213-222。new window  延伸查詢new window
9.施佳玟、李雅欣、王桂芸(20100900)。全身麻醉後低體溫引發寒顫之護理。長庚護理,21(3)=71,299-306。new window  延伸查詢new window
10.黃瑞珍、潘書嬪、黃怡慈、陳淑華(20111200)。提昇手術病人擺位安全照護正確性之專案。護理雜誌,58(6),82-89。new window  延伸查詢new window
11.陳玉紛、張慕民、潘雪幸(20140600)。接受抗癌治療之乳癌病人身體心像改變及其護理。腫瘤護理雜誌,14(1),13-24。  延伸查詢new window
12.葉淑妙(20111200)。協助一位乳癌根除術後疾病緩解期婦女經歷乳房重建之照護經驗。嘉基護理,11(2),35-46。  延伸查詢new window
13.楊秋萍、莊阿月(20091200)。一位行永久性結腸造口術個案之手術全期護理經驗。腫瘤護理雜誌,9(2),75-87。  延伸查詢new window
14.劉淑倩、黃芷誼、李秋琴、胡雅娟(20100900)。肝臟移植手術後護理指導之改善專案。長庚護理,21(3)=71,323-334。new window  延伸查詢new window
15.Alfonsi, P.(2001)。Postanaesthetic shivering epidemiology, pathophysiology, and approaches to prevention and management。Drugs,61(15),2193-2205。  new window
16.Boquiren, V. M.、Esplen, M. J.、Wong, J.、Toner, B.、Warner, E.(2013)。Exploring the influence of gender-role socialization and objectified body consciousness on body image disturbance in breast cancer survivors。Psychooncology,22(10),2177-2185。  new window
17.Bhattacharyal, P. K.、Bhattacharya, L.、Jain, R. K.、Agarwal, R. C.(2003)。Post anaesthesia shivering (PAS): A review。Indian Journal of Anaesthesia,47(2),88-93。  new window
18.Collins, K. K.、Liu, Y.、Schootman, M.、Aft, R.、Yan, Y.、Dean, G.、Jeffe, D. B.(2011)。Effects of breast cancer surgery and surgical side effects on body image over time。Breast Cancer Research and Treatment,126(1),167-176。  new window
19.Edel, E. M.(2010)。Increasing patient safety and surgical team communication by using a count/time out board。Association of Operating Room Nurses Journal,92(4),420-424。  new window
20.Schneider, F. L.、Mehrara, J. B.(2014)。De-Mythifying Breast Reconstruction: A Review of Common Misconceptions about Breast Reconstruction。Journal of the American College of Surgecos。  new window
21.朱正一、曾稼志(20110900)。骨科手術病人之健康知能、知覺同理心、術前資訊理解程度與術前焦慮之探討。醫務管理期刊,12(3),177-190。new window  延伸查詢new window
研究報告
1.衛生福利部(2012)。民國99年主要死因分析。  延伸查詢new window
其他
1.台灣乳房重建協會(2012)。年度乳房重建統計,http://www.nicebreast.com.tw/home.htm。  延伸查詢new window
圖書論文
1.吳秋燕(2011)。常見手術室環境之傷害與預防。手術室護理。台北市:華杏。  延伸查詢new window
2.劉向援(2010)。手術全期護理之原則。成人內外科護理。臺北:華杏。  延伸查詢new window
 
 
 
 
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