Vloga medicinske sestre pri ponovni vzpostavitvi samopodobe ženske po rekonstrukciji dojke : pregled literature

Bokal, Nina (author), Thaler, Darja (mentor)

Uvod: V svetu je rak dojke najpogostejša oblika raka pri ženskah. Ženske z diagnozo rak dojke pogosto trpijo še za depresijo, anksioznostjo, pojavijo se težave s čustveno nestabilnostjo, občutek fizične neprivlačnosti, upad samozavesti, spremenjena seksualna samopodoba, težave na področju partnerstva, ipd. Poznamo več načinov zdravljenja raka dojk. Najpogostejše je kirurško zdravljenje, kjer se ekscidira del ali celotna dojka. Za žensko to predstavlja veliko estetsko motnjo in vpliva na psihološko stanje. Zato se danes med samo ekscidacijo dojke istočasno izvaja še rekonstrukcija dojke s ciljem izboljšanja videza operirane dojke, kar občutno zmanjša psihološke posledice ob ekscidirani dojki. Namen: Želeli smo ugotoviti, kako rak dojke vpliva na samopodobo ženske, kako poteka ponovna vzpostavitev pozitivne samopodobe pri ženskah po rekonstrukciji dojke in kakšna je vloga medicinske sestre pri procesu zdravljenja in rehabilitacije žensk po rekonstrukciji dojke. Metode dela: Pri pisanju diplomskega dela je bila uporabljena deskriptivna metoda dela s pregledom literature. Literaturo smo iskali med januarjem in marcem 2017, z uporabo podatkovnih baz CINAHL with full text, Cochrane collaboration, MEDLINE, ter COBISS.SI. V analizo je bilo vključenih 20 člankov. Razprava in sklep: Samopodoba pri ženskah po operaciji raka na dojki je močno okrnjena zaradi izgube dojke. Ženski za vse življenje pusti telesne spremembe, to pa vpliva tudi na duševno in socialno zdravje. K hitrejši vzpostavitvi samopodobe močno pripomore rekonstrukcija dojke. Ženske se spoprijemajo z diagnozo in samo vzpostavitvijo samozavesti preko 5 faz žalovanja (model Kubler-Ross). V njih se vzbudi občutek tesnobe, negativne misli, žalost, jeza, strah in upad samozavesti. Negativna doživljanja vplivajo na zdravljenje, zato metoda s sočasno ekscidacijo in rekonstrukcijo dojke močno blaži psihološke posledice. Medicinska sestra je ključna oseba, na katero se ženska obrne, ji nudi čustveno oporo in prva opazi spremenjeno samopodobo pri ženskah. Medicinska sestra igra pomembno vlogo na vseh ravneh zdravstvenega sistema. Na primarnem nivoju večinoma skrbi za preventivo. Na sekundarnem in terciarnem nivoju ima v večini podporno in edukativno vlogo. Za kakovostno opravljanje celostne zdravstvene nege potrebuje specializirana znanja. Ženskam je kakovostna zdravstvena nega na vseh področjih zdravljenja že omogočena, potrebna pa bi bila reorganizacija nadaljnjega spremljanja ženske po odpustu iz bolnišnice.

• Language: Slovenian
• Keywords: rak dojke, zdravstvena nega, podpora, depresija, anksioznost, strah
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-93055
• COBISS.SI-ID: 5289067
• Publication date in RUL: 18.07.2017

Secondary language

• Language: English
• Title: The role of the nurse in re-establishing self-image of women after breast reconstruction : literature review

Abstract

Introduction: The most common form of cancer in women is breast cancer. During treatment and rehabilitation women with breast cancer often suffer from depression and anxiety. They also suffer emotional instability and stop feeling physical attractive which reduces their self-confidence, changes in sexual self-esteem lead to problems in partnerships, etc. There are several options of breast cancer treatment. The most common is surgery where part of or the entire breast is removed. This represents a big aesthetic impairment and it impacts psychological well-being. That is why today during breast removal surgical reconstruction of the breast is also done. The goal is to improve the appearance of the breast and significantly reduce the psychological consequences. Purpose: We wished to determine how breast cancer affects the self-image of women and what is necessary for re-establishing the self-image of women after breast reconstruction and the role of nurses during treatment and rehabilitation. Methods: A descriptive method was used with a review of literature. A literature search was performed between January and March 2017 in databases CINAHL with full text, Cochrane collaboration, MEDLINE and COBISS.YOU. 20 articles were included in the analysis. Discussion and conclusion: Self-image of women with breast cancer is significantly degraded due to the loss of the breast to surgery. It changes their bodies for a lifetime and negatively impacts mental and social health. Breast reconstruction significantly accelerates re-establishment of self-image. Women build their self-confidence through the 5 stages of grief. Feelings of anxiety, stress, negative thoughts, sadness, anger, fear, depression and decrease of self-confidence are common. Negative experiences affect treatment so simultaneous removal and breast reconstruction can prevent psychological consequences. The nurse is the key person for women. She offers emotional support and is the first to notice the change in self-image. The nurse plays an important role at all levels of the health system. At the primary level she mostly works in prevention. On the secondary and tertiary level she mostly has a supportive and educational role. Specialized nursing knowledge is needed for high-quality holistic nursing. Women receive quality nursing throughout the health care system, but a reorganization in the follow-up process after release from the hospital is required.

• Keywords: breast cancer, health care, support, depression, anxiety, fear