照護一位初次顱內動脈瘤破裂個案之護理經驗

本文描述一位初次顱內動脈瘤破裂之個案，於家中因頭痛及嘔吐後突發性意識改變，住院期間不僅忍受疾病造成的劇烈頭痛，更因肢體無力及復健成效不如預期，擔心自身會造成家庭負擔進而產生焦慮問題，故引發筆者探討之動機。護理期間自2023年5月5日至2023年5月12日，藉由直接照護、互動中觀察、會談、病歷查閱取得資料，以Gordon十一項進行評估，確立急性疼痛、身體活動功能障礙及焦慮等健康問題。於過程中透過穴位按摩、芳香療法、放鬆技巧訓練緩解疼痛健康問題，並依個別性設計復建計畫，協同復健師提供復健指導，增加肌力、維持最大活動度，提升自我照顧能力；在會談中鼓勵表達內心感受、給予心理支持，提升正向思考。由於此疾病多於突發性的產生，故建議可提供心理師或宗教師團隊介入，陪伴讓其渡過心理調適期，以積極正向面對未來漫長的復健之路，另於出院準備小組可提供視訊軟體，輔助返家後遇到困境能得到即時性回饋，確保連續性照顧品質進而提升返家後之生活品質。

關鍵字

顱內動脈瘤破裂；身體活動功能障礙；焦慮

並列摘要

This article describes a case of a first-time intracranial aneurysm rupture. He suffered a sudden change of consciousness after suffering from headache and vomiting at home. During the hospitalization, he not only endured severe headaches, but also suffered from limb weakness and less than expected rehabilitation results. He was worried about burdening his family and caused anxiety. question, thus triggering the author’s motivation for discussion. During the period from May 5, 2023 to May 12, 2023, data were obtained through direct care, observation in interactions, interviews, and medical record review, and the eleven items of Gordon were used to evaluate acute pain, physical activity dysfunction, and anxiety. and other health issues. During the process, pain and health problems are alleviated through acupoint massage, aromatherapy, and relaxation technique training. Rehabilitation plans are designed according to individual needs, and rehabilitation guidance is provided in collaboration with the rehabilitation therapist to increase the patient's muscle strength, maintain maximum range of motion, and improve himself. Caregiving ability; encourage expression of inner feelings, provide psychological support, and improve positive thinking during meetings. Since this disease often occurs suddenly, it is recommended that a team of psychologists or religious teachers be provided to intervene and accompany the patient through the psychological adjustment period, so as to face the long road to recovery in a positive manner and prepare for discharge from the hospital. The team can provide video software to help patients get immediate feedback when encountering difficulties after returning home, ensuring continuity of care and improving the quality of life after returning home.