照護一位前十字韌帶重建個案之護理經驗

本文個案是一位35歲女性因羽球運動導致右膝前十字韌帶斷裂而進行韌帶重建手術之護理經驗。護理期間為2020年8月17日至2020年8月19日，照護期間發現個案面對突發的運動傷害，不僅需面對術後傷口疼痛外，對疾病的預後表示擔心，害怕無法像以前一樣活動自如，而引發筆者書寫此報告之動機。運用Gordon十一項健康功能型態評估工具為評估依據，藉由觀察、身體評估、病歷紀錄及會談…等方式收集資料，發現個案有急性疼痛、肢體活動功能障礙及焦慮等健康問題。照護期間與個案建立良好的護病關係，提供個別性照護，教導個案選擇喜愛電視節目觀看，以分散注意力減輕疼痛感；運用跨團隊領域知識，照會復健團隊共同為個案擬定復健目標及返家復建計畫；及藉由深呼吸技巧、芳香療法-精油，透過嗅覺芳香氣味，及音樂療法轉移注意力，來減緩焦慮，協助個案以正向態度面對疾病過程，盡早恢復原有的生活型態，以提升個案生活品質，筆者期望藉此照護經驗分享，能提供護理人員在臨床照護此類似個案之參考。

關鍵字

前十字韌帶；傷口照護；復健

並列摘要

This case is about the nursing experience of a 35-year-old woman who underwent ligament reconstruction surgery due to rupture of the anterior cruciate ligament of her right knee while playing badminton.The caring period was from August 17th to 19th of 2020, during the care period, it was discovered that the patient suffered a rapid sports injury. In addition to postoperative wound pain, she was concerned about the prognosis of the disease and also afraid of not being able to move freely as previous, which triggered the author's motivation for writing this report.By applying Gordon’s Eleventh Functional Health Patterns Assessment and gathering information through observation, physical assessment, medical records and interviews, it was identified that the patient experienced health issues, such as acute pain, physical dysfunction, and anxiety. During the caring period, a good nurse-patient relationship was established and individualized care was provided. The patient was encouraged to choose her favorite television programs to distract her attention and help to ease her pain. By using cross-team field knowledge, call the rehabilitation team to jointly formulate rehabilitation goals for return home rehabilitation plans in this case. Furthermore, apply deep breathing technique, use essential oil as a form of aromatherapy as well as music therapy to divert the patient’s attention and reduce anxiety. Therefore assist the patient facing the disease process with a positive attitude, restore the previous lifestyle as soon as possible, and hence improve the quality of her life. The author hopes to make a contribution to patient care for such patients by sharing the nursing experience with nursing personnel in clinical care.

並列關鍵字

Anterior Cruciate Ligament (ACL) ； wound care ； rehabilitation

參考文獻

邱致皓（2018）．前十字韌帶斷裂．中華民國內膜異位症婦女協會會刊，25(1)，15-17。https://doi.org/10.6498/EA.201802_25(01_02).5

林雅雯、李慧芝、李靜芳（2020）．結合復健資源提升內科加護病房足部復健運動執行率．領導護理，21(2)，116-127。https://doi.org/10.29494/LN.202006_21(2).0010

莊孟昀、陳麗月（2017）．提昇外傷科病人出院前傷口自我照護正確率．長庚護理，28(2)，229-241 。 https://doi.org/10.3966/102673012017062802004

蔣昀孜、葉美玲、劉介宇（2018）．呼吸放鬆改善中風病人自律神經、疲憊、焦慮、壓力與生活品質之成效．長庚護理，29(3)，325-336 。 https://doi.org/10.6386/CGN.201809_29(3).0001

Filbay, S. R., & Grindem, H. (2019). Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture. Best Practice Research Clinical Rheumatology, 33(1), 33-47. https://doi.org/10.1016/j.berh.2019.01.018.

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