照護一位顱內出血青少年的居家護理經驗

The Home Care Experience of an Adolescent with Intracranial Hemorrhage

陳美珍(May-Jan Chen) ； 王蓉敏(Rong-Min Wang) ； 游美芳(Mei-Fang Yu)

《長期照護雜誌》 14卷3期 (2010/12) Pp. 357-369

https://doi.org/10.6317/LTC.201012_14(3).0010

摘要

本文是描述一位18歲青少年因車禍意外事故造成顱內出血，由醫院轉介至居家護理單位，照護期間自2008年10月11日至2009年1月10日。筆者藉由面談、觀察、身體評估技巧，收集個案相關資料，發現個案主要四個健康問題為：身體活動功能障礙、營養不均衡：少於身體需要、潛在危險性皮膚完整性受損及無效性因應能力。筆者訪視時除提供照護知識與技術指導外，並與家中成員討論，設計符合家人作息之病患照護計劃表（包括：灌食、翻身、活動、清潔等），鼓勵家中所有成員分擔照顧責任，因此個案居家期間未發生臥床皮膚完整性受損及肢體攣縮的合併症；另外，筆者適時引介社會福利資源，降低案父母的爲個案購買管灌食物上的經濟負荷，讓個案可以得到足夠營養及改善家庭運作。因為個案父母在申請補助的過程中，曾抱怨申請手續繁複阻擾而想放棄，故建議主管機關能整合長期照顧資源（社政與衛政）、簡化申請流程，讓資源更具可近性。

關鍵字

顱內出血 ； 青少年 ； 居家護理 ； 無效性因應能力

並列摘要

This article describes an eighteen-years-old adolescent who suffered intracranial hemorrhage due to a traffic accident. This client had been discharged from a hospital and was referred to a home care center. The period of home nursing was from October 11th in 2008 to Jan 10th in 2009. The author collected data via interviewing, observation and physical assessment methodology. After the assessment, the author found four major health problems, including impaired physical mobility; imbalanced nutrition-less than body requirements; risk for impaired skin integrity; and ineffective coping. During every visit, the author not only educated the client's family members about caring knowledge and techniques, but also discussed with them to design a life schedule (including: diet, change position, activities and hygiene) that was more suitable for the client as well as all members of the family. Then, all family members were encouraged to take responsibility of caring for the client, so there were not any complications, such as impaired skin and physical contracture which caused by bed ridden. The client also took advantage of proper social resources to lighten the caregivers' economic loads. As a result, the client can get enough nutrition and the families were empowered to cope with stress. But, the client’s parents complained that they felt discouraged because the procedure of applying for social resource is very complicated. They almost gave up contacting with officials. Therefore, it is recommended for the government to integrate long-term care resources (social affairs and healthcare), simplifying the application process and making the resources more accessible.

並列關鍵字

intracranial hemorrhage ； adolescent ； home care ； ineffective coping