一位年輕型腦中風病人之護理經驗

Nursing Experience of Caring a Young Stroke Patient

机鈺雯(Yu-Wen Chi) ； 陳芷萱(Chih-Hsuan Chen)

《長庚護理》 33卷2期 (2022/06) Pp. 140-150

https://doi.org/10.6386/CGN.202206_33(2).0013

摘要

腦血管疾病位居國人十大死因第四位，對於病人生心理的影響甚鉅，亦會改變一個家庭的發展。本文描述一位28歲年輕男性罹患出血型腦中風，接受外科顱骨切開術移除血塊後之護理經驗。照護期間於2018年11月12日至11月30日，運用Gordon十一項健康功能型態為指引，確立主要健康問題為「身體活動功能障礙」、「組織完整性受損」與「焦慮」。個案正值人生最精彩時刻，因疾病衝擊導致對未來產生焦慮不安，引發筆者撰寫動機，運用個案熟悉的香氛精油，緩解焦慮情緒；密切觀察開顱傷口，並預防感染；引導採漸進式增加肢體活動力，積極參與急性後期照護計畫。由於本院目前沒有復健治療決策輔助工具及相關教育訓練，建議未來能增加醫療決策輔助工具與推廣教育訓練，提升醫病間的溝通，帶給個案與家屬更加完善的照護。

關鍵字

年輕型腦中風 ； 身體活動功能障礙 ； 焦慮 ； 急性後期照護計畫

並列摘要

Cerebrovascular disease is currently the fourth leading cause of death in Taiwan. It has a profound impact on the patient's physiology and psychology, and will change the future development of a family's life. This article described the nursing experience of caring a 28-year-old young man suffering from hemorrhagic stroke, after undergoing surgical craniotomy to remove blood clots. The care period was from November 12 to 30, 2018. Using Gordon's eleven health function patterns as a guide, we identified the health problems as 〞physical activity dysfunction〞, 〞impaired tissue integrity〞, and 〞anxiety〞. We used familiar essential oils to relieve anxiety; closely observed the craniotomy wound; and assisted the patient gradually increase physical activity and actively participate in the acute post-care care plan. In view of the fact that there has been no decision-making aids for rehabilitation treatment and related education and training in our hospital, it is recommended that in the future, medical decision-making aids and promotion of education and training can be added to improve communication between doctors and patients to establish a comprehensive care to patients and their families.

並列關鍵字

Young stroke ； physical activity dysfunction ； anxiety ； post-acute care

參考文獻

李良彥、林昭安、張瑜芝 (2019)．腦中風急性後期整合照護計畫病人之出院後生活獨立能力進展．物理治療，44(2)，134-135。[Li, Y. L., Lin C. A., & Chang Y. C. (2019). Progress changes of functional independence after discharge of post-acute care in patients with stroke. Formosan Journal of Physical Therapy. 44(2), 134-135.] http://doi.org/10.6215/FJPT.201906.P35

李叡筠、朱彥紅、江采宜、顧家恬 (2015)．銀離子敷料於傷口照護之文獻回顧．澄清醫護 管理 雜誌，11(4)，43-50。[Li, R. Y., Chu, Y. H., Chiang, T. I., & Ku, C. T. (2015). A literature review of silver ion dressings and wound care. Cheng Ching Medical Journal, 11(4), 43-50.] http://doi.org/10.30156/CCMJ

匡貞彥、賴美玉 (2017)．運用賦權概念照護一位腦中風病人之護理經驗．長庚護理，28 (3)，487-497。[Kung, C. Y., & Lai, M. Y. (2017). Utilizing empowerment theory in nursing care for a patient with stroke. Chang Gung Nursing. 28(3), 487-497.] http://doi.org/10.3966/102673012017092803009

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。[Che, H. H., Lu M. L., Chen H. C., Chang, S. W., & Lee, Y. J. (2006). Validation of the chinese version of the beck anxiety inventory. Formosan Journal of Medicine. 10(4), 447-454.] http://doi.org/10.6320/FJM.2006.10(4).05

冼鴻曦、劉文欽、楊儀華 (2015)．有效提升中風患者的日常生活功能 - 急性後期照護之成效分析．台灣老年醫學暨老年學雜誌，10 (3)，159-171。[Hsien, H. H., Liou, W. C., & Yang, Y. H., (2015). Post-acute care improves daily activity functions of stroke patients: An effectiveness analysis. Taiwan Association of Gerontology and Geriatrics. 10(3), 159-171.] http://doi.org/10.29461/TGG.201508_10(3).0003