照護一位獨居頻跌且無望感榮民之經驗

Caring for a Solitary Veteran Who Experienced Frequent Falls and Feelings of Hopelessness

梁明玉(Ming-Yu Liang) ； 柯莉珊(Li-Shan Ke) ； 鄭慧娟(Hui-Chuan Cheng) ； 林麗華(Li-Hwa Lin)

《榮總護理》 34卷2期 (2017/06) Pp. 196-206

https://doi.org/10.6142/VGHN.34.2.196

摘要

本文描述照護一位87 歲年邁獨居榮民，因跌倒由鄰居協助就醫，住院期間因下肢無力、無法完成自我照顧，以及面對出院後的照顧問題感到無望之護理過程。護理期間2015 年02 月17 日到2 月26 日，筆者運用Gordon 十一項功能性健康模式，經由實際觀察和直接參與照護，進行資料整理分析，確立健康問題有：一、自我照顧能力不足：洗臉、刷牙、穿衣、如廁、沐浴/ 與肢體無力有關；二、高危險性跌倒/ 與下肢無力、年邁和跌倒史有關；三、無望感/ 與缺乏支持者和擔憂出院後的獨居生活有關。照護過程中，筆者依個案之個別性，與醫師、物理治療師、個案管理師、輔導員等跨領域團隊共同合作建立照護目標，並透過復健和病室內練習，增加個案肢體肌力和平衡感；藉由提供整合性照護及關懷，建立自我照顧之信心；及經由整合性照護跨團隊合作，提供中期照護和長期安置等後續照顧資源，進而改善個案生理、心理及社會調適等健康問題，提昇個案自我照顧能力和自我價值肯定。

關鍵字

自我照顧能力缺失 ； 獨居 ； 無望感 ； 跌倒

並列摘要

This paper describes a nursing experience involving caring for an 87-year-old single veteran who lives alone and was sent to hospital by his neighbor following a fall. The patient suffered from lower extremity weakness and poor self-care and was worried about his future care, which resulted in him perceiving his predicament to be hopeless. Nursing care was provided from February 17 to February 26, 2015. Gordon's 11 Functional Health Patterns Assessment was applied in this nursing process. The following health problems were identified: self-care deficits relating to lower extremity weakness; risk for falls pertaining to lower extremity weakness, frailty, and history of falls; and perception of hopelessness regarding supporters and anxiety about life after discharge. The author communicated with doctors, a physical therapist, a case manager, and a veteran consultant to set the care goals for this patient based on his individual needs. The patient's muscle strength and sense of balance were improved through rehabilitation and practice. His confidence regarding self-care was enhanced by proving appropriate care. In particular, the patient's physical and psychological concerns have been resolved by providing information regarding the options for continuing care, which included intermediate and long-term care. During this care process, the patient's self-care ability and self-affirmation were increased.

並列關鍵字

self-care deficit ； solitary ； hopelessness ； fall

參考文獻

朱哲生、陸悌(2011)．失眠之最新概況．台灣醫界，54(6)，8-14。

吳曼阡、宋惠娟(2010)．光線治療在老人照護的運用．志為護理，9(3)，63-70。

李秋香、顏文娟、黃秀梨(2009)．無望感之概念分析．嘉基護理，9(1)，7-11。

郭貞吟、高秀娥、黃貴薰(2014)．使用Orem自我照顧理論照顧一位股骨頸骨折老人之護理經驗．新臺北護理期刊，16(1)，63-72。

傅純雅、李美雲(2010)．協助一位社會資源貧乏之跌倒老人居家自我照顧護理經驗．安泰醫護雜誌，16(3)，181-192。