透過您的圖書館登入
IP:3.137.218.230
  • 期刊

運用歐倫理論於一位近端股骨骨折老年患者自我照顧之護理經驗

The Nursing Experiences of caring an Elderly Patient with Proximal Femoral Fracture Using Orem's Theory

摘要


本文旨在運用歐倫理論協助一位近端股骨骨折老年患者自我照顧之護理經驗。因個案過去自我照顧及跌倒的挫敗經驗,加上患肢疼痛、活動受限等身體不適,造成個案焦慮於未知的治療結果與疾病預後。返家後家屬僅可提供有限協助,藉此契機,於照護期間2014 年9 月24 日至10 月12 日激發個案自我照顧動機並促進自我照顧能力。經由觀察、會談、身體評估及病歷查閱等技巧收集資料,確認主要健康問題有三項,包括:一、急性疼痛/ 與右腿創傷及缺乏疼痛處理技巧有關;二、自我照顧能力缺失/ 與欠缺自我照顧動機和技能有關;三、焦慮/ 與術前對手術或未來健康狀況不明有關。運用Orem 自我照顧理論及專業團隊人員合作,以增進個案各層面健康之自我照顧能力,包括緩解其疼痛、焦慮及降低活動障礙,激發個案對復健、預後及合併症預防之動機與增強信心,協助達成自我照顧知識與技能。本文提供醫護人員日後照護類似案例之參考,建議針對骨科老年患者自我照顧能力評估與護理宜早期介入,藉此促進老人患者自我照顧並提升患者術後照護品質。

並列摘要


The case report describes the nursing experiences of promoting self-care of an elderly with a proximal femoral fracture by applying Orem's theory. The patient, who had a history of falling, suffered from lower limb pain, limited mobility, and anxiety about her treatment outcome and prognosis after surgery. Her family could offer only limited assistance once she returned home. By taking this opportunity, the authors were excited to trigger the motivation of the self-care and to promote the self-care ability of this case during the period of nursing care (from September 24, 2014 to October 12, 2014). Observation, interviews, physical assessment, and medical record reviews were used to gather information. Several health problems were identified, including acute pain, self-care deficits, and anxiety. For the three major health problems, the authors applied Orem's self-care nursing theory and professional staff team collaboration to enhance the patient's self-care ability at all health levels, including strategies to ease pain, anxiety, and interventions to minimize movement disabilities. The authors also worked with her to improve both her motivation to achieve rehabilitation and her confidence regarding her self-care abilities. The authors hope that this study may be used as a reference in similar conditions. Early assessment for self-care skills of elderly orthopedic patients can lead to improve self-care and enhance the quality of postoperative care of patients.

參考文獻


李昭憲、楊燦、賴家欣、鄭麗櫻(2014)。探討骨科患者內固定復位手術前後焦慮感及其相關因素之研究。美和學報。33(1),95-108。
Kuo, C. C.,Lin, C.C.,Lee, W. J.,Huang, W. T.(2013).Comparing the antiswelling and analgesic effects of three different ice pack therapy durations: A randomized controlled trial on cases with soft tissue injuries.Journal of Nursing Research.21(3),186-193.
蔡芸芳、陳文哲、黃慈心、徐郭堯、葉文凌、詹益聖(2015)。比較兩種疼痛評估工具之結果:以膝骨關節炎老人為例。長庚護理。26(2),137-147。
吳啟明、李淑芬、李美文、何清治、洪錦墩(2015)。台灣髖部骨折病人手術失敗率之分析:以人口為基礎的世代研究。臺灣公共衛生雜誌。34(5),476-490。
Bernard, H.,Foss, M.(2014).The impact of the enhanced recovery after surgery (ERAS) programme on community nursing.British Journal Community Nursing.19(4),184-188.

延伸閱讀