照顧一位青年創傷後左膝下截肢之護理經驗

A Nursing Experience of Caring a Post-trauma Young Adult Receiving Left Below Knee Amputation

邱珮華(Pei-Hua Chiu) ； 王玉琴(Yu-Chin Wang)

《長庚護理》 32卷1期 (2021/03) Pp. 104-114

https://doi.org/10.6386/CGN.202103_32(1).0009

摘要

經歷截肢要面對的是一個永久性的喪失，面對突如其來的改變，常造成生活及社交很大的衝擊，產生重大挫折與自卑。本文描述一位20歲之青年因創傷導致左膝下截肢之護理經驗。護理期間為2018年4月9日至5月11日，運用Gordon十一項健康型態功能評估，藉由觀察、傾聽、會談、身體評估、病歷資料查閱方式進行主客觀資料收集並分析整理，確立個案身心受創並產生急性疼痛、身體心像紊亂、身體活動功能障礙等健康問題，於照護過程中運用放鬆技巧減緩疼痛，給予關懷、心理支持，使個案接受身體外觀的改變，加上醫療團隊與家屬建立良好的支持系統，使個案正向的態度面對截肢的事實，重新適應日常生活自我照顧，因筆者於學生實習期間從沒有照護截肢個案，又是與自己年紀相仿的，畢業後初至臨床工作，第一次照護截肢的個案，期望藉此護理經驗分享，提供臨床護理人員照顧青年截肢病患之參考。

關鍵字

青年創傷 ； 截肢

並列摘要

A person who encountered amputation had to deal with permanent bodily impairment. With the unexpected accident, it brought significant impacts on patient's life and interpersonal relationship and resulted in great frustration and feeling of inferiority. This paper described the nursing experience of caring a 20-year-old young adult who received left below knee amputation due to trauma. The nursing period began from April 9^(th) to May 11^(th) of 2018. Whilst Gordon eleven Function Health Patterns was administered, the data collection was subjectively and objectively conducted via observation, listening, interview, body assessment, and medical record review for analysis. It indicated that the patient suffered from physical and psychological trauma with comorbidity of acute pain, body image disturbance, and bodily function impairments. During the medical care, means of relaxation were applied to reduce pain level with caring and psychological support. In order to make the patient accept his physical change, a well supporting network was built between the medical team and patient's family to enable the patient to handle amputation with a positive attitude and to adapt to patient's daily life. It was my first clinical experience to provide nursing care to an amputated patient; therefore, I looked forward to sharing my experience to nurses on first line caring similar patients.

並列關鍵字

Young Adult Trauma ； Amputation

參考文獻

何嘉莉、吳麗敏 (2019)•協助一位糖尿病血液透析病人面臨再次截肢後身體心像紊亂之護理經驗 • 臺灣腎臟護理學會雜誌，18(1)，76-89。[Ho, C. L., & Wu, L. M. (2019). Providing assistance to a diabetic hemodialysis patient dealing with body image disturbance arising from a second amputation. Taiwan Journal of Kidney Nursing, 18(1), 76-89.]https://doi.org/10.3966/172674042019061801006

何頌揚、何姍蓉 (2015)• 從轉譯科學觀點探究鏡像治療於幻肢痛之轉譯過程 •臺灣職能治療研究與實務雜誌，11(1)，50-58。[Ho, S. Y., & Ho, S. J. (2015). Translation point of view: Mirror therapy in phantom limbs pain. Taiwan Journal of Occupational Therapy Research and Practice, 11(1), 50-58.]https://doi.org/10.6534/jtotrp.2015.11(1).50

林佳琪、蔡衣帆、楊式辰 (2014)•失明糖尿病個案接受截肢手術之護理經驗－個案報告 •北市醫學雜誌，11(2)，206-218。[Lin, C. C., Tsai Y. F., & Yang, S. C. Yang. (2014). Nursing experience on caring a blind diabetic patient with below-knee amputation: A case report. Kita Medical Journal, 11(2), 206-218. https://doi.org/10.6200/TCMJ.2014.11.2.09

林儷玲、林紹雯、李彩緣 (2019)• 一位車禍截肢之中年男性患者之護理經驗 •秀傳醫學雜誌，18(1)，62-70。[Lin, L. L., Lin, S. W., & Lee, C. Y. (2019). The experience of nursing a middle-aged patient with an amputation due to accident. Xiu Chuan Medical Journal, 18(1), 62-70.]https://doi.org/10.3966/156104972019061801008

洪締鵑、黃盈菁 (2016)• 照顧一位外籍勞工斷指重建失敗後截肢之護理經驗 • 長庚護理，27(1)，144-155。[Hung, T. C., & Huang, Y. C. (2016). Nursing experience of caring for a foreign worker undergoing amputation after the failed severed finger replantation. Chang Gung Nursing, 27(1), 144-155.]https://doi.org/10.3966/102673012016032701014