- 期刊
運用羅氏適應護理模式於一位創傷性胸椎損傷病人之護理經驗
The Nursing Experience of a Patient with Thoracic Injuries through Roy's Adaptation Model
摘要
本文旨在敘述一位因車禍造成胸髓損傷導致下肢癱瘓，而失去自我控制能力並感到無望的個案照護經驗。個案因肢體張力未如預期改善，因而引發身心困擾。於2015年9月22日至10月29日護理期間，運用羅氏適應護理模式之生理功能、自我概念、角色功能及相互依賴等評估概念架構，經由觀察、會談、身體評估及病歷回顧之方式收集資料，確立個案住院期間主要健康問題為：身體活動功能障礙、現存性泌尿道感染、自我照顧能力缺失、無望感及個人因應能力失調等。針對影響個案適應程度因素，運用護理措施，包括：調整適合個案的病床高度，以利轉位；運用無菌技術，進行間歇性清潔導尿；提供相關衛教書面資料，如穿衣、沐浴、如廁技巧衛教單張；給予正向鼓勵強化回饋機制，增進個案正向的感受；協助個案了解面對失落的現實情況及鼓勵描述失落的感受，使個案在面對生理及心理的雙重打擊下，能增加對疾病的認知而重建自信心，並與家屬討論及參與照顧計劃，以共同面對疾病的壓力，透過人性關懷使個案能主動且積極的運用有限之肢體能力以適應新的生活。
並列摘要
This article describes the nursing experience of a case with lower-limb paralysis due to chest spinal cord injury caused by a car accident and the loss of hope and self-control. The nursing period was from September 22 to October 29, 2015. Roy's adaptation model was used to collect physiological functions, self-concepts, role functions, and the interdependence of the nursing model with the conceptual framework through observation, an interview, a physical assessment, and a chart review. The identified problems included impaired physical mobility, an risk of urinary tract infection, self-care deficit, hopelessness, and risk of ineffective coping. According to the behavior and root causes influencing the patient, a proper nursing process was applied to this case. This improved the patient's mental and physical states, and the researcher enabled the patient to increase her awareness of her condition to rebuild her confidence under the mental and physical double strikes. We also assisted her family in participating in this care plan to face the pressure of her condition together. Furthermore, we helped them search for social resources and push the patient to accept the fact of her condition and adapt to her new life actively and positively. Therefore, the researcher presents this nursing experience to share it with you.