Priprava pacientke na odpust po rekonstrukciji dojke - aktivnost oblačenja : diplomsko delo

Kovač, Valentina Pika (author), Milavec Kapun, Marija (mentor), Gogova, Tina (co-mentor), Ovijač, Darja (reviewer)

Uvod: Zaradi povečanja števila obolelih pacientk za rakom dojke se povečuje tudi število pacientk za rekonstrukcijo dojke. Le ta je sestavni del zdravljenja raka dojk. Ena izmed nalog medicinske sestre pri obravnavi žensk po rekonstrukciji dojke pri temeljni življenjski aktivnosti oblačenja in slačenja je priprava pacientk na odpust. Namen: Namen je predstavitev priprave pacientk na odpust po kirurški rekonstrukciji dojke. Osredotočili se bomo na temeljno življenjsko aktivnost - oblačenje in slačenje, ki predstavlja veliko oviro pri izvajanju vsakodnevnih aktivnostih v domačem okolju. Pri tej temeljni življenjski aktivnosti imajo pacientke težave, saj je gibanje rok omejeno. Predstavili bomo posebnosti, navodila medicinskih sester in potek odpusta pacientk z vidika oblačenja in slačenja. Metode dela: Uporabljen je bil fokusni etnografski pristop raziskovanja. Raziskava je bila izvedena na kliničnem oddelku. Rezultati: Predstavljena so kompresijska oblačila, ki jih pacientke uporabljajo po rekonstrukciji dojke na izbranem kliničnem oddelku. Povzeta so vsa navodila, ki so predan pacientkam ob odpustu. Pri aktivnosti oblačenja in slačenja mora medicinska sestra pacientko naučiti pravilne tehnike oblačenja in slačenja, izbora primernih oblačil in pravilnega higienskega vzdrževanja elastičnih oblačil. Ob tem nudi pacientkam tudi čustveno oporo. Razprava in zaključek: Kompresijsko oblačilo morajo pacientke po operaciji nositi ves čas hospitalizacije in doma, držati se morajo danih navodil. Naloga medicinske sestre je, da pacientko nauči pravilne tehnike oblačenja in slačenja kompresijskih oblačil glede na omejitve, ki se pojavijo po rekonstrukciji dojke. Ob odpustu bi bila zaželena literatura v pisni obliki (trenutno jo pacientke dobijo le ustno), v obliki zgibanke in samega odpustnega lista. Odpustna navodila so kratka, posplošena, vsebujejo en stavek, ki se navezuje na nošenje elastičnih oblačil, zato so trenutno zelo pomembna ustna navodila medicinske sestre. Našli smo nekaj novih možnosti nadgradnje ustnih in pisnih navodil. Za zagotavljanje strokovne in celostne obravnave pri odpustu potrebuje medicinska sestra specialna znanja s področja plastične rekonstrukcije, onkologije, edukacije in komunikacije. V prihodnosti bi bila smiselna priprava odpustnih navodil tako v papirnati zloženki kot v elektronski, video in mobilni obliki.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, rak dojke, odpustna navodila, kompresijska oblačila
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [V. P. Kovač]
• Year: 2020
• Number of pages: 37 str.
• PID: 20.500.12556/RUL-124108
• UDC: 616-083
• COBISS.SI-ID: 45824259
• Publication date in RUL: 31.12.2020

Secondary language

• Language: English
• Title: Preparing to discharge a patient after breast reconstruction - dressing activity : diploma work

Abstract

Introduction: Due to the increasing number of breast cancer patients, the number of breast reconstruction patients is also increasing. This procedure is an integral part of the treatment of breast cancer. One of the activities of nurses in caring for women after breast reconstruction is to prepare patients for discharge, which should include also activities of dressing. Purpose: It was introduced the preparation of patients for discharge after breast surgery. The focus is on the basic activity – dressing and undressing, which is a major barrier to carry out patients' daily activities in the home environment. Patients have problems with this basic activity as the movement of arms is limited. The focus is on the specific instructions and the health education as part of the preparation for the discharge regarding activity dressing and undressing. Methods: A focused ethnographic approach to research was used. The research was carried out in the clinical department. Results: Compression clothes used by patients after breast reconstruction are presented. All instructions for patients after discharge regarding using clothes and dressing are summarised. In the activities of dressing and undressing the nurse should teach the patient the right dressing and dressing techniques, select suitable clothing and how to maintain the elastic clothing properly. It also gives the patient emotional support. Discussion and conclusion: After the operation, patients must wear compression clothing and follow the instructions. To provide professional and comprehensive treatment, nurses need special knowledge in the field of plastic reconstruction, oncology, education and communication. Nurses also educate the patient on the correct techniques of putting on and off compression clothing according to the limitations that occur after breast reconstruction. Prior to discharge, written information in the form of a leaflet and a discharge nursing documentation should support oral information. Nowadays medical instructions in discharge documentation regarding dressing and wearing compressing clothing are short, generalized; nurses provide just oral instructions. Some suggestions for updating oral and written nursing instructions are made. In the future, it would be useful to add discharge instructions both in paper brochures as well as in electronic, video and mobile formats to be created.

• Keywords: diploma theses, nursing care, breast cancer, discharge instructions, elastic compression garments