title: [Nursing experience with a schizophrenic breast cancer patient after mastectomy].
abstract: This case study used cognitive therapy to improve the life quality of a 46-year-old woman with chronic schizophrenia who had undergone a mastectomy for breast cancer. This case had suffered from schizophrenia for over 24 years and was hospitalized in the chronic ward of our hospital. Breast cancer was revealed during an annual comprehensive physical checkup. In May 2012, this case received a right mastectomy at a local hospital. After the surgery, she was readmitted to the psychiatric acute ward for further care from May 30th to August 28th, 2012. A holistic nursing assessment was conducted that addressed five major aspects. The major nursing problems found during hospitalization were: acute pain, body image disturbance, and low self-esteem. A decline in pain score from 10 to 4 was achieved by developing rapport with the patient, empathizing with her distress, and providing active care to the wound. Her body image changed because of loosing her breast. Her acceptance of the loss improved through helping her to explore her feelings of change. To improve her self-esteem, we offered cognitive therapy to change her negative thinking process. She became more sanguine and cheerful. Moreover, her dependence in terms of activities of daily living decreased. This individualized intervention contributed to the recovery of a post-mastectomy, schizophrenic patient from low self-esteem.
authors.affiliation: Department of Nursing, Tsaotun Psychiatric Center, Ministry Health, Taiwan, ROC.
authors.forename: Jia-Rong
authors.initials: JR
authors.lastname: Lin
authors.affiliation: Department of Nursing, Tsaotun Psychiatric Center, Ministry of Health, Taiwan, ROC. mllin@ttpc.mohw.gov.tw.
authors.forename: Mei-Ling
authors.initials: ML
authors.lastname: Lin
mesh_terms: D001943:Breast Neoplasms / Q000451:nursing / Q000523:psychology* / Q000601:surgery; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000451:nursing / Q000523:psychology*; D008875:Middle Aged; D012559:Schizophrenia / Q000628:therapy*; D012649:Self Concept
keywords: breast cancer; long-term low self-esteem; schizophrenia