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We remain in the midst of the global COVID-19 epidemic. As of November 11th, 2020, cases of COVID-19 have been confirmed in 189 countries/regions around the world, with a total of 51,510,611 confirmed cases and more than 1,275,211 deaths, with a global fatality rate of 2.48% (Taiwan Centers for Disease Control, Ministry of Health and Welfare, ROC, 2020b). Therefore, countries are facing lockdown crises and their populations face daily lives full of chaos, anxiety, and reorganization. The characteristics of this epidemic are most often described as "unprecedented" and replete with "uncertainty" (Davidson et al., 2020). In order to prevent the spread of this virus, health measures such as quarantine, wearing protective masks, and enforced lockdowns have been adopted by governments around the world, producing psychosocial (emotional distress, anxiety, suicide) and economic side-effects (Lima et al., 2020; Montemurro, 2020). Despite its close geographical proximity to China, Taiwan's number of confirmed infections has been relatively small (584 people diagnosed as of November 11th, with 7 total COVID-19-related fatalities; Taiwan Centers for Disease Control, Ministry of Health and Welfare, ROC, 2020b). Taiwan's tragic experience 17 years ago with the SARS epidemic helped prepare the government to respond rapidly to the COVID-19 threat, make thorough preparations and advanced deployments, and formulate relevant anti-epidemic border control measures, quarantine and isolation measures, mask-wearing requirements, and public education strategies. Actions such as mask wearing, washing hands frequently, and practicing proper social distancing by the public and the government maintaining a master travel history, occupation, contact history, and cluster (TOCC) database have proven effective in detecting and diagnosing cases early (Taiwan Centers for Disease Control, Ministry of Health and Welfare, ROC, 2020a; Yang et al., 2020). Furthermore, providing first-line personnel with appropriate protective equipment, education, and training as well as timely and transparent information and epidemic prevention guidelines have kept nurses supplied with appropriate personal protective equipment, infection-prevention and control education, training and exercises, and sufficient professional knowledge and skills to provide care safely to patients (Chen et al., 2020; HuangChen, 2020; Yang et al., 2020). Concurrently, it has been a challenge to nursing educators regarding how to suspend classes while not stopping academic education and to plan meaningful, alternative clinical experiences during the pandemic (Morin, 2020) and how to redefine and evaluate student performance to maintain teaching quality and learning effectiveness. In addition, "disaster nursing" is a critical area of professional knowledge for nurses in the 21st century, and all nurses should have an appropriate level of competence in professional disaster nursing. Therefore, core concepts related to infection control, disasters, and disaster preparedness should be incorporated into the curriculum and objectives. Finally, although we in Taiwan have faced the COVID-19 challenge in an environment in which the pandemic risk has been relatively well controlled, our daily lives are no longer taken for granted. When we look back on this experience, what will we learn from these experiences and how will this experience change how we approach healthcare and pandemic threats in the future? These changes will bring us more thoughts and challenges in nursing.新型冠狀病毒肺炎疫情下的回顧與護理省思.全球疫情仍持續延燒著，截至2020年11月11日止，已在全球189個國家／地區確診病例，累計51,510,611人確診超過1,275,211人死亡，全球致死率2.48%（衛生福利部疾病管制署，2020b）。因此各國陷入封城危機，日常充滿混亂、不安與重整。最常以「前所未有」（unprecedented）和「不確定」（uncertain）來描述這種流行病特徵（Davidson et al., 2020）。為了防止病毒傳播，世界各國政府已採取健康措施（例如隔離，戴防護面罩，封城鎖國）產生了心理社會（情緒困擾、焦慮、自殺）和經濟影響（Lima et al., 2020; Montemurro, 2020）。儘管台灣地理位置與中國非常接近，但與許多國家相比，台灣確診感染人數相對少（截至11月11日止584人確診，7人死亡；衛生福利部疾病管制署，2020b）。由於台灣經歷17年前SARS的慘烈突擊，政府對COVID-19能及早因應，做好周全準備與超前部署，制定相關防疫政策，包括：邊境管制、檢疫隔離措施、口罩政策、宣導教育（戴口罩、勤洗手、保持社交距離），也掌握旅遊史、職業別、接觸史及是否群聚（TOCC: travel history, occupation, contact history, cluster）可早期偵測及發現個案，即時安置個案與暴觸者（衛生福利部疾病管制署，2020a；Yang et al., 2020），提供第一線人員適當防護裝備、教育訓練，快速、公開、透明的資訊與防疫指引，使護理師能獲得適當個人防護裝備，接受感染預防與控制教育訓練及演練，具備足夠的專業知識與技能，提供病人安全的照護（陳等，2020；黃、陳，2020；Yang et al., 2020）。同時，也挑戰著護理教育者，如何在不可抗之疫情下，停課不停學和計畫有意義的替代臨床經驗（Morin, 2020），重新定義如何評值學生之表現，以確保教學品質及學習成效。此外，「災難護理」是廿一世紀護理人員必備的專業知能，護理人員應有緊急救災的專業能力，因此，有關感染控制、災難和備災的核心概念宜納入課程與宗旨。最後，在台灣的我們雖有驚無險地共同經歷挑戰，日常也不再理所當然。當我們回顧此經驗時，我們將從這些經驗中學到什麼，以及這些學習可能帶來的變化？這些變化，將帶給我們護理更多省思與挑戰。.

The concept of body image has been applied in various disciplines, including neurology, clinical psychology, psychopathology, behavioral science, and nursing (Cash, 2004; Rhoten, 2017). Meleau-Ponty (1962) identified the body as the subject of perception and considered the body not as an object but as an embodied subject that lives in the world. "Body image" refers to an individual's body, which generates a sensory message through contact with the environment during internal physiological operations and establishes a preliminary mental understanding of the body (Schilder, 1970). Body image is also affected by the external environment. As Plato remarked, "We are bound to our bodies like an oyster is to its shell." Indeed, our life experiences are integrally influenced by the body we happen to live in (Cash, 2004). Because body image is formed primarily by individuals interacting with others, Schilder (1970) called body image a social entity. People desire to keep their body image intact and unaffected by changes, damage, or losses in terms of function or body parts. Any change is perceived as a threat and thus induces anxiety and fear (Rochlin, 1973). In caring for a patient facing body-image changes, a nurse may help the patient using her in-depth knowledge of the potential impacts of this change on the body, mind, social relationships, bodily functions, self-concept, and self-esteem (Roberts, 1978). Under what circumstances do individuals experience body image change? The most common clinical conditions of body image change are: perceiving sensational change (physical discomfort/signs and symptoms), receiving medical treatments/procedures (receiving blood transfusions, injections, punctures), receiving nursing interventions/ procedures (enema, urethral catheterization) pain, taking medications (moon face), experiencing amputation/dysfunction or alteration/disfigurement, becoming pregnant or undergoing labor, acquiring physical diseases or injuries (cancer, HIV/AIDS, skin diseases, burns), and experiencing role failure (Cash, 2004; Rhoten, 2017; Roberts, 1978). Therefore, when a patient complains to a nurse about physical discomforts, it is necessary to understand that the patient is experiencing body image change and will benefit from timely and effective assistance to overcome and accept this change. Body image change is an important issue that should continue to be better understood and addressed in the field of nursing. This article provides a rich account of body image discourse that may be used as a reference in clinical nursing care, education, and research.身體意象於臨床的重要性.「身體意象」概念已被各種學科所應用，包括神經學、臨床心理學、精神病理學、行為科學、以及護理學（Cash, 2004; Rhoten, 2017）。Meleau-Ponty（1962）將身體視為知覺的主體（the subject of perception），認為我們的身體不是一個客體，而是生活於世界中一個體現的主體（an embodied subject），所以，人都是經由我們身體來知覺世界，也因而能生活於世界中。而身體意象是指一個人的身體，經由身體內在生理運作與環境接觸後產生知覺訊息，在腦中建立起對自己身體的一種初步認識的結果（Schilder, 1970）。身體意象也受外在環境所影響，如同柏拉圖評論「我們的身體像牡蠣一樣被它的外殼所束縛」，我們的生活經驗完全受到我們身體所處環境的影響（Cash, 2004），這些多變的身體意象，它的形成主要是個人與其他人的互動，因此，Schilder（1970）稱身體意象是一個社會整體（social entity）。人都希望保持身體意象的完整，不要有改變、損壞，不要失去功能或身體的部分。任何改變都是一種威脅，會引起焦慮和害怕（Rochlin, 1973）。當護理人員照顧一位經歷身體意象改變（body image change）的病人時，若能深入了解身體意象的改變會帶給病人身、心及社會面的衝擊，而致影響其身體功能、自我看法以及身為一個人的自尊，才是一位對病人有幫助的護理人員（Roberts, 1978）。然何種情況下，個體會經驗身體意象改變？臨床上最常見的情況就如，當病人抱怨著身體感覺的改變（身體不適／徵象和症狀）、接受醫療措施（抽血、打針、穿刺等)或護理措施（灌腸、導尿等）、疼痛、服用藥物（月亮臉）、截肢／功能喪失或改變、缺陷、或懷孕和生產，罹患疾病或損傷（癌症、愛滋病、皮膚病或燒傷等）以及角色功能的喪失等（Cash, 2004; Rhoten, 2017; Roberts, 1978）比比皆是。因此當病人向護理人員主訴身體不適時，要能理解此時病人正經歷身體意象改變之衝擊，而要如何適時地、有效地協助病人克服並接受身體意象改變，是一門有待護理界繼續學習的一大課題。本期刊提供豐富的身體意象論述，可提供臨床實務照護、教學以及研究之參考。.

Although the concept of body image was first introduced to Taiwan nursing in 1975, its application in the context of clinical nursing with regard to promoting humanistic patient-centered care has yet to be examined. This paper adopts a field-study approach to reinterpret the concept of body image with deeper and broader strength using patient vignettes, nursing case studies, and the findings of prior nursing research. The four main issues covered in this paper are: 1. The body image concept, 2. Building body schema and a postural model based on body experiences, 3. The characteristics of body image, and 4. The extended meaning of body image, including self-concept and the role function of relationship. This paper is expected to help nurses better understand the concept of body image and further apply this concept in clinical practice in order to improve the provision of humanistic patient-centered care.身體意象與臨床護理之應用.「身體意象」概念最初是於1975年引介到台灣護理界，然應用此概念於護理情境，促進「以人為本」的護理仍有待重新檢視。本文的目的是以更深更廣的個案觀點，個案研究和使用護理田野研究法的結果，來重新詮釋「身體意象」概念。因此，本文藉由介紹四個議題：(1)「身體意象」是什麼；(2)透過身體經驗建構「身體基模」與「身體姿態模式」；(3)有關「身體意象」特性；(4)「身體意象」延伸意義：與「自我概念」及「角色功能」關係，期望護理人員應用「身體意象」概念於病人照護，能讓護理走向「以人為本」境界的最有效途徑。.

Breast cancer is a major disease threating women. From diagnosis and treatment through regular follow-ups, patients with breast cancer may experience physical and mental discomfort and pain caused by disease and treatment-related symptoms. These symptoms may further affect disease progression, emotional state, health function status, quality of life, and survival. Symptom experience is as a dynamic process that expresses a patient's feeling regarding the totality of his or her experience. Symptom experience involves the patient's perception of the frequency, intensity, distress, and meaning that accompany the production and expression of symptoms. Cancer patients often experience multiple symptoms distress. Although these symptoms may occur in isolation, multiple symptoms are typically experienced simultaneously. Therefore, obtaining information from patients about the occurrence and distress of their symptom experience is essential to assess their symptom experiences. The present article presents an overview of symptom experiences, explores breast cancer symptom clusters, and analyzes related factors of influence for patients with breast cancer. The authors hope that the findings will help nurses better understand the symptom experiences of breast cancer patients and further apply this understanding in clinical practice in order to assess symptom experiences correctly and to provide more appropriate interventions to improve quality of care.乳癌病人的症狀經驗.乳癌為威脅婦女的主要癌症，病人從診斷、治療至追蹤的各階段，皆可能經歷因疾病及治療所衍生的症狀經驗所導致的身心不適與痛苦，甚至影響疾病進展、情緒狀態、健康功能狀態、生活品質及存活。症狀經驗是一個動態過程，是病人對症狀整體的體驗、感受，包含症狀發生、症狀困擾，以及症狀對病人的意義或重要性，尤其是癌症病人常同時經驗到單獨或多個症狀一起發生的困擾。因此，從病人的角度來看整體症狀經驗是必要的，本文藉由對癌症症狀經驗概念的介紹、探討乳癌病人的症狀群集，以及彙整其相關研究，並提出護理實務應用之建議，期望提昇護理人員對症狀經驗概念的理解和掌握，以能正確評估和提供符合現實及病人需要之措施，進而提升整體照護品質。.

Up to 11% of women with mastitis develop a breast abscess, which obviously affects breastfeeding. Therefore, this is a potentially significant issue for women's health. Women with breast abscesses suffer from severe pain. Pain is the most significant factor causing the termination of breastfeeding. The experience of women with breast abscesses who continued to breastfeed may provide valuable insights/guidance to women who are currently in the same or similar situations.This study explores the continuous breastfeeding experience of women with breast abscesses.We collected qualitative data from 10 qualified female participants using 60-90 minute, in-depth interviews that were conducted between April 2012 and June 2012 in a central medical center. All interviews were recorded and transcribed verbatim. Content analysis was used to analyze and categorize the major themes.Results were generalized into the following seven themes: (1) experiencing uncomfortable breast pain; (2) feeling helpless to manage the abnormal breast symptoms; (3) relying on the concept of motherhood to support continued breastfeeding; (4) feeling shocked about the process of diagnosis and treatment; (5) facing the doubts and difficulties regarding continuing to breastfeed; (6) experiencing the assistance of the support system for breastfeeding; (7) returning to a normal pattern of life.The findings provide nurses with a deeper understanding of the biological and psychological behaviors and social support system experiences of women with breast abscesses who continue to breastfeed. Study results may serve as a reference for nurses in providing mother-centered breastfeeding care.罹患乳房膿瘍婦女持續哺乳之經驗.泌乳期有高達11%乳房發炎的婦女會發展成乳房膿瘍，顯著影響母乳哺育，是潛在重要的婦女健康議題。乳房膿瘍的症狀使婦女經歷強烈的疼痛，疼痛是最主要導致中止母乳哺餵之因素。瞭解持續哺育乳房膿瘍婦女之經驗，可作為協助類似經歷婦女之參考。.探討泌乳期婦女從罹患乳房膿瘍至治療期間持續哺乳之經驗。.採質性研究，於2012年4月至6月在某醫學中心婦產科門診，以半結構性訪談指引進行60-90分鐘訪談，共選取10位婦女，每位婦女訪談兩次，訪談所得資料寫成逐字稿，並以內容分析法進行資料分析與歸納。.歸納七主題，分別為（一）歷經乳房疼痛之不適；（二）面臨處理症狀求助無門之感慨；（三）仰賴為母信念堅持哺乳；（四）震驚乳房膿瘍之診治過程；（五）游移於持續哺乳或放棄之抉擇；（六）感受支持系統之助力；及（七）重返正常生活節奏。.本研究結果有助於護理人員深入瞭解乳房膿瘍婦女面臨泌乳期乳房膿瘍時，生、心理與社會支持系統之行為反應，及其面臨醫療處置之經驗，可作為護理人員提供符合婦女哺乳照顧需求之參考。.