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| 題 名 | 運用精準健康照護模式於一位乳癌切除併重建個案之手術全期護理=Applying the Precision Healthcare Model in the Perioperative Care of a Patient Undergoing Mastectomy with Breast Reconstruction Surgery |
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| 作 者 | 林泯佑; 蔣玉滿; | 書刊名 | 新臺北護理期刊 |
| 卷 期 | 27:1 2025.03[民114.03] |
| 頁 次 | 頁134-143 |
| 分類號 | 419.8234 |
| 關鍵詞 | 精準健康照護模式; 乳癌; 重建手術; 手術全期護理; Precision health care model; Breast cancer; Reconstruction surgery; Perioperative care; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6540/NTJN.202503_27(1).0012 |
| 中文摘要 | 本文運用精準健康照護模式於一位乳癌切除併重建個案術後對身體外觀改變的衝擊之護理經驗。因筆者身為乳癌切除案例家屬身份,更能感同身受個案對經歷此手術的不安及擔憂,而引發筆者探討此個案之動機。護理期間於2022年12月11日至2022年12月23日,運用精準健康照護模式及手術整體性護理評估,透過觀察、會談、傾聽等方式收集資料,針對個案生理、心理、社會及靈性層面進行分析,確立主要健康問題為:焦慮、潛在危險性手術情境傷害、急性疼痛、身體心像紊亂等。針對個別性問題執行相關護理措施,運用跨團隊照護模式詳細說明手術過程,以減輕個案對疾病和手術的焦慮;落實手術期間病人安全照護標準,防止因使用手術器械而造成的組織損傷;教導局部按摩及非藥物輔助治療轉移注意力,以減輕疼痛;以過來人身份分享,適時提供乳房重建資源,並介紹成功案例及乳癌病友協會義工訪視,增強個案的自信心;主動關懷,傾聽個案內心感受,並利用服裝修飾外貌,引導個案以正向態度面對身體外觀的轉變,並鼓勵家屬參與照護,促使個案返家後,能夠順利地適應正常生活。建議醫院能成立乳房重建個案管理團隊,並有效發揮臨床手術全期護理師的角色功能,藉以提升乳癌個案的照護品質。 |
| 英文摘要 | This article presents the nursing experience of utilizing the Precision Health Care Model in managing the impact of postoperative body appearance changes on a patient who underwent breast cancer removal and reconstruction. The author has personal experience as a family member of a breast cancer excision case and thus can empathize with the patient's anxiety and worries during this procedure. This motivated the author to explore this particular case. From December 11 to December 23, 2022, utilizing the Precision Health Care Model and comprehensive surgical nursing assessment, data was collected through clinical interviews, attentive conversations, direct surgical care, and collaborative care with specialized physicians and dedicated nurses. The physiological, psychological, social, and spiritual aspects of the case were analyzed, and the main health issues were identified as anxiety, potential harm from the surgery, acute pain, and body image disturbance. Individualized nursing measures were implemented to address these problems. The multidisciplinary care model was employed to explain the surgical process in detail, thereby reducing anxiety related to the disease and surgery. Adherence to surgical patient safety care standards prevented tissue damage caused by surgical instrument use. Local massage and non-pharmacological adjunctive therapies were taught to divert attention from pain. Providing guidance as a survivor, appropriate resources for breast reconstruction were offered, along with introducing successful cases and arranging visits from breast cancer support group volunteers to enhance the patient's confidence. Active care and attentive listening were provided to understand the patient's inner feelings. Clothing and appearance modifications were utilized to guide the patient towards a positive attitude in coping with physical appearance changes, and involving family members in the care process facilitated a smooth transition back home and adaptation to normal life. This enhances the role and function of perioperative nurses, and it is recommended to establish a breast reconstruction case management team in the future to improve the quality of care for patients in similar situations. |
本系統中英文摘要資訊取自各篇刊載內容。