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| 題 名 | 照護一位食道癌手術病人接受術後加速康復(ERAS)之護理經驗=Nursing Experience from Caring for an Esophageal Cancer Surgery Patient Who Received Enhanced Recovery after Surgery (ERAS) |
|---|---|
| 作 者 | 李家芳; 張家蓁; | 書刊名 | 領導護理 |
| 卷 期 | 26:1 2025.03[民114.03] |
| 頁 次 | 頁83-95 |
| 分類號 | 419.821 |
| 關鍵詞 | 食道癌; 食道重建手術; Esophageal cancer; ERAS; Esophageal reconstructive surgery; |
| 語 文 | 中文(Chinese) |
| DOI | 10.29494/LN.202503_26(1).0007 |
| 中文摘要 | 本文描述罹患食道癌男性,因擔憂手術恢復期長、職場被取代,選擇術後加速康復療程(ERAS)介入食道重建手術,降低術後生、心理不適、併發症,縮短住院天數及加速身體機能回復,重拾自信回歸職場之護理經驗。護理期間為2022年3月27日至4月5日,藉由會談、觀察、直接照護及依照Gordon十一項功能性健康型態評估等方式收集資料,確立病人急性疼痛、營養少於身體所需、身體心像紊亂等健康問題。照護過程中首先滿足生理需求,主動評估疼痛指數,依據ERAS多重模式疼痛控制指引、合併輔助治療如音樂治療、按摩、分散注意力以舒緩疼痛。接著運用跨領域團隊合作與營養師共同討論並設計飲食計畫,改善病人營養問題;同時藉由陪伴、傾聽、鼓勵表達內心感受、介紹成功案例,教導正向思考及自我肯定,協助面對與調適疾病帶來身體心像改變的衝擊,提升自我照顧能力、改善焦慮,進而提升生活品質。出院後筆者利用電訪持續追蹤居家生活,以達連續、整體性之全人照護。建議可拍攝多媒體教材及製作空腸造瘻口模具,藉由觸摸模具降低心中恐懼、排斥,提早接受身體心像改變,爭取充裕時間做出院前準備,增進返家後生活品質。 |
| 英文摘要 | This article describes the caring experience of a male patient with esophageal cancer, who was concerned about a long recovery period will contribute to the replacement of his current job. He chose an Enhanced Recovery after Surgery (ERAS) intervention for esophageal reconstruction to reduce postoperative stress, psychological discomfort, and complications which aims to shorten hospitalization days, and accelerate physical recovery to regain confidence and return to work. During the nursing care period from March 27 to April 5, 2022, data was collected through interviews, observations, direct care and incorporate with Gordon's 11 Functional Health Assessment to identify health issues include acute pain, insufficient nutrition to satisfy body requirement, and also body dysmorphic disorder. The care process begins with meeting physiological needs, proactively assessing pain indices, and following ERAS multi-modal pain management guidelines, as well as incorporating complementary therapies such as music therapy, massage, and distraction to relieve pain. Hence apply cross-disciplinary teamwork to discuss and design a dietary plan with a nutritionist to improve the patient's nutritional problems. At the same time, through companionship, listening, encouraging the expression of inner feelings, introducing a successful case, teaching positive thinking and self-affirmation, help facing and adjusting to the impact of physical and psychological changes caused by the disease, enhancing self-care ability, improving anxiety, and further enhancing the quality of life. After being discharged from the hospital, the author used telephone interviews to follow up on the home life of the case to achieve continuous and holistic care. It is recommended to undertake multimedia educational materials and make fistula molds to lessen fear and rejection. By touching the molds, getting use to accept the change in body and mind earlier, and to gain sufficient time to make pre-hospital preparations in order to improve the quality of life after returning home. |
本系統中英文摘要資訊取自各篇刊載內容。