運用Levine's Conservation Model於早產兒之護理經驗

The Experience of Nursing a Preterm Infant Based on Levine's Conservation Model

張和美(Ho-Mei Chang) ； 蔣立琦(Li-Chi Chiang)

《榮總護理》 23卷4期 (2006/12) Pp. 412-420

https://doi.org/10.6142/VGHN.23.4.412

摘要

對照護早產兒而言，其最終目標不只是救活就好，更應維持生理的穩定、避免早產兒的結構受到傷害、維護神經發展的能力及成功的整合嬰兒回到家庭。本篇個案報告為運用「李文能量保存模式」(Levine's Conservation Model)於早產兒之護理經驗。筆者在94年2月至5月擔任個案的主護護士期間，以病歷記錄、觀察法、非結構性的會談收集相關資料，運用Levine四個保存原則作為早產兒護理評估的架構，歸納個案的健康問題有能量保存、結構完整性、個人完整性及社會完整性受威脅。計畫護理措施包括：(一)減少能量耗損及提供必要能量以維持早產兒的能量保存；(二)透過精密的監測與保護措施協助個案渡過生理不成熟的挑戰；(三)調節適當的環境刺激與個別化發展性照護措施，維護個人知覺感受發展的完整；(四)減少家屬分離焦慮與鼓勵參與照顧活動以穩定家庭系統進而維護社會完整。文中利用Levine四個保存原則作為照護早產兒的理論架構，期望能將理論應用於臨床實務中，由臨床實務來驗證理論，並提供其他護理人員作為臨床應用的參考。

關鍵字

早產兒 ； 護理 ； 李文能量保存模式

並列摘要

The ultimate objective of caring preterm infants was not only to ensure survival, but also maintaining physical stability, avoiding structural impairment, keeping neurodevelopment, and integrating the preterm infant into the family. This paper reported a nursing experience of caring for a preterm infant based on Levine's Conservation Model. Data was collected from the chart records, observations, and unstructured interviews from February, 2005 to May, 2005 while this author as primary nurse was using Levine's Four Conservation Principle as a nursing assessment guideline, and health problems were inducted include threat to the balance of energy conservation, threat to structural integrity, threat to personal integrity, and threat to social integrity. The nursing interventions taken included: (1) reducing energy expenditure and providing necessary intake to keep the preterm infant’s energy conservation, (2) monitor closely and using protective procedures to help infant adapt to an extra-uterine challenge with immature organs, (3) adjusting environment stimulating factors with individualized developmental care to maintain function of personal sensory perception, (4) reducing family's separation anxiety and encouraging involvement care activities to stabilize the family's system for social integrity. The author used Levine's Four Conservation Principle as a framework, hoping this theory could apply to clinical practice, and from practice test the theory. We expect other nurses to put it into practice as well.

並列關鍵字

preterm infant ； nursing ； Levine's Conservation Model