一位出血性腦中風後無望感病人之照護經驗

本文係描述一位中年男子因左側殼核出血性腦中風導致生活失能，致使身心備受煎熬，產生失落感。筆者於2021年12月1日至2021年12月30日照護期間，以Gordon十一項功能性健康型態評估，確立個案有身體活動功能障礙、家庭因應能力失調、無望感之健康問題。藉由觀察、溝通、陪伴、關懷、同理與支持等方式，鼓勵個案主動表達內心正、負向心理感受及面對的壓力，提供預防腦中風二次復發等專業的護理指導，並協助轉介跨領域醫療團隊人員，讓個案及家屬共同參與擬訂與執行復健計畫，以面對腦中風帶來的後遺症，提升個案復健治療的信心與希望，增加復健動力，進而改善身體活動功能障礙及無望感；增進家庭成員互動，繼而改善家庭因應能力失調的問題，協助病人及其家庭成員能面對日後日常生活型態之改變。希望藉本文照護經驗提供臨床照護參考，分享個案身、心、靈、家庭問題與需求的評估與照護。

關鍵字

出血性腦中風；失能；跨領域團隊合作照護；無望感

並列摘要

This article describes a middle-aged man who was disabled after a left putamen hemorrhagic stroke incidence, causing physical and mental agony as well as a sense of disappointment to his family and society. During the nursing period from December 1, 2021 to December 30, 2021, we conducted a comprehensive assessment on the patient's physical, psychological, social and spiritual aspects to determine the patient's impaired physical mobility, ineffective family coping, and hopelessness. We encouraged the patient to express their inner positive and negative feelings and pressure they face through communication, observation, companionship, care, empathy support, etc., and provided professional nursing knowledge as well as appropriate guidance to prevent the second recurrence of stroke. Referral of interdisciplinary medical team members as well as increasing participation for patients and their families in rehabilitation plans can help the patient to face the complications after stroke, increase the patient's confidence and hope for recovery, and promote recovery motivation, which eventually improve physical dysfunction and ease the sense of hopelessness. Strengthening interaction between family members can also help to improve family adaptive skills, and assist patients and the patient and his family members to face future changes in daily life patterns. The purpose of this article is to provide our nursing experience for holistic health care. We seek to understand the needs of the patient's body, mind, spirit, and family, to help these desperate patients in the future.