照顧一位腦中風病人成功脫離呼吸器之護理經驗

本文描述一位43歲出血性腦中風個案成功脫離呼吸器之護理經驗。筆者於2020年3月27日至4月11日，藉由觀察、筆談、理學檢查及直接照護等方式，運用Gordon十一項功能健康型態進行整體性評估，確立呼吸道清除功能失效、身體活動功能障礙及無望感之健康問題。經由跨領域團隊及家庭支持系統合作之下，指導漸進式呼吸訓練、個別性復健計畫、有效咳嗽技巧及關節活動的重力、阻力訓練等，並透過觀看復健衛教影片，分享復健成功案例中，運用同理引導個案主動表達內心感受以激發學習及復健動機順利成功脫離呼吸器，重新找回生命中的希望。期望藉由本文照護經驗提供臨床照護類似個案，協助個案建立自信心，進而提升生活品質。

關鍵字

腦中風；呼吸器脫離；無望感

並列摘要

This study described the nursing experience of caring for a 43-year-old hemorrhagic stroke patient who was successfully weaned from the respirator. From March 27 to April 11, 2020, the researcher applied observations, written communication, physical examinations, direct care and so on to utilize Gordon's Eleven Functional Health Patterns to conduct the holistic assessment, and established the health problems included airway clearance failure, physical function disabilities, and sense of hopelessness. Under the cooperation of a cross-field team and the family support system, the researcher instructed the case to implement progressive breathing techniques, an individualized rehabilitation plan, effective coughing skills, gravitational forces on joint movements, and resistance training. The case was encouraged to watch a rehabilitation health education video and was enlightened about the successful cases of rehabilitation shared. The researcher applied empathy to guide the case to proactively express inner feelings in order to stimulate motivation for learning and rehabilitation, and hence successfully weaned from the ventilator and regain hope in life. Hopefully by sharing this nursing experience, we can provide a reference for clinical care of similar cases to assist patients building self-confidence and further improve their quality of life.

並列關鍵字

stroke ； weaning from the ventilator ； sense of hopelessness

參考文獻

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徐琦溦、林穎函、張詩怡、蔡佩蓉、沈姿君、林幼麗（2020）‧多元創新策略於腦中風病人早期肢體復健計畫‧護理雜誌，67(1)，81-88。https://doi.org/10.6224/JN.202002_67(1).10

孫麗君、蔡佩卉、黃家儀、陳淑惠（2017）‧提升外科加護病房胸腹手術後肺部復健執行率‧高雄護理雜誌，34(2)，28-39。https://doi.org/10.6692/KJN-2017-34-2-3

郭喬閔、蔡衣帆、陳頌云、楊時芳、林美玲（2018）‧慢性阻塞性肺病運用肺部復健脫離呼吸器之護理經驗-個案報告‧北市醫學雜誌，15(2)，111-122。https://doi.org/10.6200/TCMJ.201806_15(2).0012

許家萍、陳柔均、黃麗靜（2019）‧照顧一位腦中風年輕個案面對無望感之護理經驗‧馬偕護理雜誌，13(1)，18-28。https://doi.org/10.29415/JMKN.201901_13(1).0002

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照顧一位腦中風病人成功脫離呼吸器之護理經驗

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