一位腦中風失能病人出院準備服務之護理經驗

Nursing Experience of Discharge Planning for a Disabled Patient due to Cerebrovascular Accident

林淑華(Shu-Hua Lin) ； 黃秋玲(Chiu-Ling Huang)

《領導護理》 19卷4期 (2018/12) Pp. 73-86

https://doi.org/10.29494/LN.201812_19(4).0006

摘要

本文個案是一位出血性腦中風導致長期臥床之病人的護理經驗，因再度入院以及因照顧壓力讓有憂鬱傾向的個案女兒想自殺，是引發筆者照護之動機。筆者照護個案自2015年9月22日至2015年11月20日期間，共進行訪視8次、電訪2次，藉由身體評估、整合性家庭評估，確立有三項健康問題包括：皮膚完整性受損、照顧者角色緊張、無效性因應能力。筆者根據個案管理原則，提供完整的出院準備服務，包括在個案住院期間提供疾病衛教、照顧技巧之外，適時協調家中成員共同參與照顧，減輕主要照顧者負荷，且提供主要照顧者運用基金會及社區照顧資源長期照顧管理中心相關居家照顧服務，進而幫助案家解決相關照顧問題。家庭功能障礙須透過心理輔導協助，建議相關單位增設專業家庭諮商課程，訓練專業護理人員協助更多家庭，也希望藉由作者出院準備服務經驗分享，提供護理人員在照顧類似個案時可參考。

關鍵字

腦中風 ； 出院準備

並列摘要

This article is about caring for a long-term bedridden patient due to hemorrhagic stroke. His frequent readmission and caring burden had triggered his daughter's depression and suicidal behavior, and that was the motivation for the author to initiate the caring process. The author provided care to this client, from the 22nd of September to 22nd of November in 2015, during this time, the author conducted ten interviews, twice with telephone and eight times personal visits. After physical assessment and integrative family evaluation, the author identified three health issues: broken integrity of integument, tension of caregiving, and inadequate coping skills. Based on the principles of case management, the author provided comprehensive discharge services: supply illness information and skill of caring during admission, at the same time engaging other family members to relieve burden of the main caregiver. The author also tried to guide the main caregiver to acquire other resources, such as foundation or community long-term care resource center. Through this enduring effort, the author finally helped this family gone through this difficult situation. Family dysfunction requires psychological counseling, it is advisable for relevant department to incorporate family counseling lessons, provide training for professional nurses to assist more families. The author would like to share this experience as a contribution of valuable reference to nursing practitioners to care for patients under similar situation.

並列關鍵字

Stroke ； Discharge planning

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