照顧一位腦中風後無望感患者之護理經驗

Nursing Experience in Caring for a Patient Experiencing Hopelessness After a Stroke

卜心怡(Hsin-Yi Pu) ； 游雅梅(Ya-Mei Yu)

《榮總護理》 34卷1期 (2017/03) Pp. 49-56

https://doi.org/10.6142/VGHN.34.1.49

摘要

本文描述ㄧ位63 歲老人罹患腦中風五年後身、心理變化之護理經驗，筆者於2015 年8 月8 日至8 月14 日照護期間藉由直接訪談、觀察、護理照護等方式，運用Gorden 十一項功能性健康型態進行評估，個案有吞嚥障礙、身體活動功能障礙而引發無望感等健康問題。運用跨團隊全人照護執行吞嚥訓練計畫，讓個案能安全的由口進食，協助個案及家屬共同參與復健計畫與活動，以維持身體與社會功能的最佳狀況。因個案中風後身體功能退化而出現無望感心理問題，筆者鼓勵並接受個案正負向感受的表達，使用非語言肢體關懷及具體提出其優點，使其以正向的態度渡過無望感過程，提升個案與照顧者之生活品質。期望此護理經驗有助提升護理人員對腦中風個案之照護。

關鍵字

腦中風 ； 吞嚥障礙 ； 無望感

並列摘要

This article describes the nursing experience of treating a 63-year-old man with stroke with dysphagia and psychological changes. During daylight care from August 8 to August 14, 2015, Gordon's 11 functional health patterns were used as guidance to collect the patient's medical history and data. The results revealed that the patient's health problems included a swallowing disorder, physical activity dysfunction, and hopelessness. In the nursing process, dysphagia associated with the disposal of providing care ensured that it was safe for him to eat orally, encouraged him and his family to participate in the codesign of rehabilitation programs, and maintained his physical and social function in the best condition possible. Hopelessness was due to the physical and psychological problems from having a stroke; the use of nonverbal caring skills and encouraging the patient to express his positive and negative feelings helped him and his family to overcome the feelings of hopelessness. We expect that sharing our experience will provide nursing staff with a reference for providing care in similar cases.

並列關鍵字

stroke ； dysphagia ； hopelessness

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