照顧一位頸椎後韌帶骨化症術後個案之護理經驗

本文描敘69歲男性因頸椎後韌帶骨化症術後右側肢體乏力導致無法執行日常生活，以負向情緒因應之護理經驗。護理期間2018年06月19日至07月31日。運用Gordon十一項健康功能型態進行整體性評估歸納「身體活動功能障礙」、「呼吸道清除功能失效」及「無力感」之護理問題。執行復健及肌力訓練，日常生活活動量表由15分提高至60分；教導個案深呼吸咳嗽技巧及給予胸腔物理治療，促進個案有效咳痰,維持呼吸道通暢；運用傾聽、陪伴了解個案的擔憂，引導面對解決壓力能力、提供個案參與護理活動，賦予主動執行復健運動計畫，提升自我照顧能力與信心。建議醫療團隊在疾病初期提供相關衛教影片、早期會診心理師了解心理需求、介入同質性支持團體，提供個案疾病認知、心理支持，冀望藉此護理經驗分享，提供臨床護理人員照顧此類病人時，能協助個案以正向、積極態度克服身體活動功能障礙，面對未來的生活。

關鍵字

頸椎後韌帶骨化症；呼吸道清除功能失效；無力感

並列摘要

This article describes the nursing experience of a 69-year-old man who was unable to perform daily life due to weakness of his right limb after surgery for ossification of the posterior cervical ligament, and responded with negative emotions.During the period of postoperative care from June 19 to July 31, 2018, the author used Gordon's 11 Functional Health Patterns Assessment tool to evaluate the nursing problemswere "physical activity dysfunction", "respiratory clearance failure "and" senseof powerlessness ".Perform rehabilitation and muscle strength training, increase the activity of daily living scale from 15 points to 60 points; promote effective sputum expectoration and keep the airway unobstructed; use listening and companionship to understand the concerns of the case, guide the ability to solve stress and provide case participation Nursing activities are empowered to actively implement rehabilitation exercise plans and enhance self-care ability and confidence. It is recommended that the medical team provide relevant health education videos at the early stage of the disease, early consultation with psychologists to understand psychological needs, intervene in homogeneous support groups, provide case awareness and psychological support, and hope to share nursing experience and provide clinical nursing staff when taking care of such patients , Can help the case to overcome the physical activity dysfunction with a positive and positive attitude and face the future life.

並列關鍵字

ossification of posterior cervical ligament ； respiratory clearance failure ； sense of powerlessness

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