一位粉塵爆炸燙傷個案之護理經驗

本文旨在描述照護一位粉塵爆炸燒燙傷個案的護理經驗。大面積燒燙傷初期所產生的劇烈疼痛及身邊無家屬陪伴給予心理支持，導致個案產生極度恐懼引發筆者撰寫動機。於2015年6月27日至7月5日照護期間，藉由Gordon十一項健康功能型態為評估架構，運用身體評估、觀察、會談、傾聽及溝通等方式收集資料，確立個案主要之健康問題依序為無效性呼吸- 吸入性損傷、皮膚完整性受損-燒燙傷傷口及恐懼。照護過程中發現個案不但要面對內心因創傷導致的恐懼心情及身處於陌生住院環境的不安全感，還要承受身體上的疼痛反應，極為渴望家人的支持及關懷與陪伴，因此照護期間，在醫療團隊努力與個案建立良好的治療性人際關係及互動，給予個案心理支持，積極傾聽並同理其感受，讓家屬及個案共同參與治療計畫，並用手機Line軟體，請家屬錄製加油鼓勵話語，讓個案感受到溫暖，降低恐懼感，進而促進復原，及早面對及接受改變後的自己，恢復信心走向人群，以新心情展開新的人生。

關鍵字

粉塵爆炸；燙傷；恐懼

並列摘要

This paper described the nursing experience of caring of a burn patient by a dust explosion disaster. This case was admitted from June 27 to July 5 in 2015. The Gordon's eleven functional health patterns were used for assessment. Information were collected by physical evaluation, observation, consultation, listening and communicating. The health issues identified included ineffective breathing, inhalation injury, impaired skin integrity, burn and fear. During admission, the patient faced not only the post-trauma related fear and insecurity but also extreme physical pain. The care plan included seeking supports from family members. The main focus of care in the hospitalization period was to established good relationship with the patients and family members, to provide emotional supports, and to invite family members to participate in treatment plans. By using communication software such as LINE and having family members record their message to encourage the patient and provide security, making earlier recovery and preparation for new life become possible.