照護一位學齡期兒童外傷性手指截斷接受顯微重建之護理經驗

The Experience of Providing Nursing care for A School-age Child after Receiving Microsurgery and Replantation of Amputated Finger

陳淑貞(Shu-Chen Chen) ； 康瑞蘭(Jui-Lan Kang)

《長庚護理》 28卷3期 (2017/09) Pp. 498-508

https://doi.org/10.3966/102673012017092803010

摘要

本文描述一位十一歲個案正處於學齡期，因右手不慎被機器捲入，導致右手食指截斷。筆者於2015 年2 月3 日至2 月10 日在照護期間，經由直接護理、會談、傾聽、查閱病歷等方式收集資料，以Gordon 十一項功能性健康模式作整體性評估，確立個案的主要健康問題有：疼痛、恐懼、潛在危險性周邊神經血管功能失常、照顧者角色緊張等。依學齡期發展特性，以醫療卡通圖解說明手術步驟，運用繪畫及布偶遊戲等緩解個案的恐懼；以樂高積木和電玩遊戲等來轉移疼痛的注意力；監測患部血液循環變化，製作抽煙及吸二手煙警示牌等，促進末梢血液循環的穩定；提供疾病衛教單張以口語化來說明照護技巧，介紹類似經歷的家庭經驗分享，提升主要照顧者的照護能力，進而降低不安。

關鍵字

學齡期 ； 手指截肢 ； 顯微重建

並列摘要

This research concerns an 11-year-old school-age kid (＂the patient＂) whose right hand was trapped in a machine and the index finger was severed as a result. The author provided care to the patient from February 3rd to 10th in 2015, during which the information was collected through nursing care, conversation, and medical record. Gordon's functional health patterns was used to evaluate the patient. The patient was confirmed to have the following health issues: pain, fear, risk for peripheral neurovascular dysfunction, and caregiver's anxiety. Considering the patient's development stage, cartoon characters were used to explain surgical procedures, drawing and puppet plays were utilized to reduce fear in patient, and Legos and video games were used to shift patient's attention from pains; surgical site was monitored for blood circulation, no-smoking and second-hand-smoke signs are in place to encourage stabilization of peripheral circulation; an easy-to-follow one-page post-surgical care instruction was offered to the caregivers; families with similar background are invited to sharing their experience; these techniques are implemented to help caregivers, which in turn reduce their anxiety.

並列關鍵字

school age ； severed finger ； reconstructive microsurgery

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