- 期刊
- Ahead-of-Print
照護一位因酗酒造成股骨頭缺血性壞死個案的護理經驗－個案報告
Nursing Experience of a Young Patients with Avascular Necrosis of the Femoral Head Due to Alcoholism: A Case Report
摘要
本篇報告旨在描述一位因酗酒造成雙側股骨頭缺血性壞死行全髖關節置換術病人的護理經驗。護理期間為2020年8月2日至8月15日，運用Gordon十一項健康功能型態為評估工具，以身體評估、觀察、會談及直接照護等方式完成資料收集。經評估分析後，發現個案健康問題主要有：（一）急性疼痛與術後傷口及換藥拉扯傷口有關；（二）身體活動功能障礙與急性疼痛、患肢肌力減少及活動受限有關；（三）焦慮與擔憂術後肢體無法正常行走及面臨失業有關。藉由與個案建立良好護病關係，提供藥物止痛、深呼吸及轉移注意力，有效減輕術後疼痛，使個案疼痛指數由9分降至4分；協助執行術後床上肌力訓練增加肌肉強度，住院期間右下肢肌力可由1～2分進步至出院時3分；予護理指導、傾聽、教導減輕焦慮的方法，透過醫療專業人員團隊共同參與出院後安置事項，使個案積極配合復健治療，提升自我照顧能力，能回歸日常生活，貝克焦慮量表由26分降至3分。藉由此個案之照護經驗分享，期望提升酒癮病人接受全髖關節置換術的照護品質提供照護此相關個案之參考。
並列摘要
This report describes the nursing experience caring for a patient who underwent total hip replacement due to bilateral avascular necrosis of the femoral head caused by alcoholism. The nursing period was from 2 August to 15 August 2020. The patient's health status was assessed using the Gordon's 11-item Functional Health Pattern, and the following health problems: (1) acute pain related to postoperative wounds and change of wound dressings; (2) physical mobility impairment related to acute pain, decreased muscle strength of affected limbs and limited activities; (3) anxiety and worry about being unable to walk normally after surgery and facing unemployment. The patient's postoperative pain was effectively reduced from 9 to 4 points, along with establishing a good nurse-patient relationship, drug treatment, and the practice of deep breathing and diversion of attention. We assisted the patient in performing postoperative in-bed muscle strength training to increase muscle strength, and that of the right lower extremity improved from 1 to 2 points during hospitalization to 3 points at discharge. We provided nursing guidance, listened to the patient, and taught the patient approaches to reduce anxiety. With the involvement of medical professionals in planning post-discharge placement, the patient actively cooperated in the rehabilitation program, improved self-care ability, and returned to daily life. The Beck Anxiety Inventory was reduced from 26 points to 3 points. Through sharing experiences, we offer this case as a reference for improving the quality of care for alcoholism patients undergoing total hip replacement.