- 期刊
一位腦中風併閉鎖症候群患者之照護經驗
Nursing Experience from Caring a Stroke Patient with Locked-In Syndrome
摘要
即使肉體箝制於潛水鐘內，禁錮的靈魂仍渴望著有朝一日能像蝴蝶一樣翩然起舞。本文描述一位中年男性個案在正值豐富的生產力階段罹患腦中風併發閉鎖症候群，雖然意識清楚，卻喪失語言及活動能力，只能利用眼球移動和外界交流的護理經驗。筆者於2017年12月19日至2017年12月28日期間，運用Gordon十一項健康功能型態評估，並經由直接護理、觀察及會談等技巧進行收集資料，確立個案有呼吸道清除功能失效、自我照顧能力缺失、無望感、照顧者角色緊張之健康問題。筆者除了協助維持個案生命徵象的穩定及呼吸道通暢外，也透過表情圖卡和教導個案以眼球移動的方式表達感受。在家屬對於氣切問題意見不一致時，筆者協助傳達個案意願，使家屬了解雙方想法，進而做出決策。此外，藉由帶領案妻一同參與照護過程和提供社會福利資源等資訊，不僅讓案妻了解照護方式外，也使個案後續的照護問題得到妥善的處理，讓個案和家人能倚靠家庭的支持力量，得以扶持彼此面對未來的挑戰。建議未來照護此類個案時，除了可偕同語言治療師建立一套個別性的溝通圖文卡或利用科技資訊輔具外，也要適時運用家庭支持力量，降低疾病對身體和家庭社會的衝擊。
並列摘要
Even though the body is clamped in the diving bell, the detained soul is still longing to dance like a butterfly one day. This article illustrates the experience of nursing a middle-aged male patient who suffered from locked-in syndrome as a complication of stroke at the lavish productive time during his life. Although still conscious, he has lost his verbal ability and physical mobility, he can only communicate through eye movements with the outside world. During the nursing period from December 19th to 28^(th) of 2017, the author applied 'Gordon's Eleven Functional Health Patterns' in the assessment and performed data collection using techniques such as direct nursing care, observation, and interview. The nursing issues identified include: ineffective airway clearance, insufficient self-care, hopelessness, and caregiver role strain. In addition to help stabilize the patient's vital signs and ensure airway clearance, the author used facial expression cards and taught the patient to express his feelings through eye movements. When family members had dispute on issues regarding tracheotomy, the author helped to convey the intentions of the patient, enhancing mutual understanding between the patient and his family for further facilitating decision-making. Furthermore, by inviting the patient's wife to participate in the caring-giving process and providing her with information about social welfare and other resources, the author not only familiarized her with nursing techniques but also ensured that nursing problems were properly handled subsequently. The patient and his family members can thus rely on family support from the family members when they face challenges of the future. In regards to similar nursing cases in the future, it is suggested that speech therapists to be engaged to create a set of tailor-made graphic cards for communication or assistive technology and information devices be incorporated. Apart from that, we should also ensure timely support from the patients'families to ease the impact of disease on the health of the patients, families, and society.
參考文獻
延伸閱讀
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