乳房切除手術後之身體心像衝擊－以一位老年婦女為例

Cancer has a great impact on people's lives, especially for woman with breast cancer and those who need to face the changes of physical appearance after receiving mastectomy. The purpose of this case report was to assist an elderly woman who received mastectomy using Watson's caring theory, emphasizing the human caring nature through establishing a therapeutic relationship in order to achieve treatment and nursing goals. The nursing period was from August 30 to September 3 in 2013. We used observation, therapeutic conversation, physical assessment, physical care, and family interaction to collect information. Through information collection and analysis, three major health problems of this elderly woman were established including anxiety, disturbance of body image, and lack of knowledge. We used empathetic listening and supportive caring based on well-established therapeutic relationship to assist this elderly woman to express one's feelings and clarify questions regarding the disease. Furthermore, we provided her and her family with the pre- and post- operation precautions, post-operative rehabilitation and special underwear and other needed information in order to alleviate her inner anxiety and sense of exclusion. Ultimately, this elderly woman could adapt to changes in physical appearance and daily activities habits. Recommendations for future clinical nursing care of such elderly patients can be first to establish a trust relationship, and then provide elderly patient with holistic care which consists of physical, psychological and social care of a whole person.