運用周全性老年評估照護一位反覆肺炎住院長者之護理經驗

Nursing Experience of Applying Comprehensive Geriatric Assessment to an Elderly Patient With Recurrent Pneumonia

蔡昀蓁(Yun-Chen Tsai) ； 楊淑慧(Shu-Hui Yang) ； 張嘉珣(Chia-Hsun Chang)

《榮總護理》 35卷3期 (2018/09) Pp. 322-329

https://doi.org/10.6142/VGHN.201809_35(3).0011

摘要

本文描述一位高齡96歲長者因反覆性肺炎感染導致日常生活功能衰退，出現憂鬱情緒及無望感之身心困擾；護理期間自2017年6月07日至6月20日，以病歷收集、身體評估、傾聽、觀察及會談等方式收集資料，運用周全性老年評估量表進行整體性護理評估及訪談，確立個案有自我照顧能力缺失、無望感及潛在危險性肺吸入等健康問題。住院期間藉由跨專業領域團隊合作提供整體性及持續性照護，加強預防吸入性肺炎措施及口腔衛生清潔，預防再次肺炎入院，鼓勵個案參與復健，提升日常生活自我照顧功能並運用懷舊治療，回顧以往豐功事蹟，順利開心地返回原居住地；出院後利用電訪方式與照護人員交班照護計劃及飲食、復健相關注意事項，以利持續提供照護。由於高齡長者皆合併多種慢性病、多重用藥，使其診斷及治療複雜度增加，而運用周全性老年評估量表及早介入發掘個案現存和潛在問題很重要，建議加強實務訓練課程，將周全性老年評估量表推廣至各照護單位而不侷限於高齡病房中，讓長者可得到更妥善照護。

關鍵字

高齡長者 ； 周全性老年評估 ； 肺炎

並列摘要

This article describes the nursing experience of a 96-year-old individual with repeated pneumonia infections and loss in self-care ability. The nursing period was from June 7 to 20, 2017. Patient information was collected through physical assessments, observations, and an interview; subsequently, the functional health patterns of the comprehensive geriatric assessment (CGA) were applied to assess the patient thoroughly. The following health problems were identified: impaired self-care ability, hopelessness, and risks of aspiration of pneumonia and multiple chronic diseases. This paper illustrates the importance of utilizing CGA for early intervention and for discovering the current and existing health problems of elderly patients. Practical training courses should be strengthened to promote CGA to all care units without limitation to the wards caring for elderly patients.

並列關鍵字

older adults ； comprehensive geriatric assessment (CGA) ； pneumonia

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