運用自我效能理論護理一位全膝關節置換術後病人之經驗

Nursing Experience of Using Self-Efficacy Theory to Care for a Patient Undergoing Total Knee Replacement

李柏勳(Po-Hsun Lee) ； 林思親(Sic-Hing Lin) ； 蕭詠勳(Yung-Hsun Hsiao)

《榮總護理》 40卷1期 (2023/03) Pp. 66-73

https://doi.org/10.6142/VGHN.202303_40(1).0007

摘要

本篇病人報告分享運用自我效能理論，護理一位接受全膝關節置換術後病人之經驗，照護期間自2020年10月5日至10月12日止。筆者藉由觀察、身體評估及會談等方式蒐集資料，依據五大層面進行整體性評估，確立主要健康問題有急性疼痛、身體活動功能障礙及焦慮；護理期間以Bandura的自我效能理論為核心概念，透過與病人、家屬及跨團隊醫療照護，共同討論疼痛控制、制訂居家復健計劃及確保安全的居家環境，成功激發病人復健動機，並降低可能受傷的心理焦慮，再透過家訪及電訪持續追蹤及鼓勵病人持續自我照顧。期望能運用此護理經驗，提供日後臨床護理人員照顧膝關節置換病人之參考。

關鍵字

全膝關節置換術 ； 自我效能 ； 復健

並列摘要

This article describes our experience of using self-efficacy theory to care for a patient who underwent total knee replacement. The nursing period was October 5 to 12, 2020. Observation, physical assessment, and interviews were conducted to collect data for major nursing assessments. Three major health problems were noted: acute pain, impaired physical mobility, and anxiety. Our medical team designed a care plan with the patient and their family. This plan focused on providing pain relief, home-based care and rehabilitation, and a safe home environment to facilitate patient participation in rehabilitation programs and reduce their anxiety. During follow-up, home visits and telephone interviews were conducted to evaluate the patient's self-efficacy and encourage the patient to maintain self-care. Our findings may guide clinical nursing care for patients undergoing total knee replacement.

並列關鍵字

total knee replacement ； self-efficacy ； rehabilitation

參考文獻

李尹暘、林曉佩、林君怡(2007)．自我效能理論之分析與應用．澄清醫護管理雜誌，3 (2)，46-52。

車先蕙、盧孟良、陳錫中、張尚文、李宇宙(2006)．中文版貝克焦慮量表之信效度．台灣醫學，10 (4)，447-454。

黃靜怡、李怡珍(2018)． 全膝關節置換術後病人延遲下床活動之改善專案．高雄護理雜誌，35 (3)，37-47。

蔡玉梅、莊峰玲、陳冠蓁、陳寶珍(2020)．以賦權式術前衛教提昇膝關節置換術病人之自我照顧效能．榮總護理，37 (1)，14-24。

賴建成、陳郁君、雷涵媮、張至宏(2020)．退化性膝關節炎再生醫學治療及醫病共享決策之應用．臺灣醫學，24 (6)，659-664。