照護一位燒燙傷導致右手肘下截肢病人之加護經驗

本文敘述一位雙上肢及前胸燒燙傷面積達30%之65歲獨居女性，於2020年3月13日至2020年4月16日以身心靈社會四大層面進行整體性評估，發現個案有急性疼痛、自我照顧功能缺失、焦慮等健康問題；於照護過程說明換藥方式，配合深呼吸放鬆技巧與自備熟悉物品及聆聽音樂來分散對疼痛注意力；與各職類跨團隊專業合作，強化肢體訓練，使用特殊可調式餐具及碗底具有吸盤或止滑墊固定利於自行進食，讓個案增加生活自理的自信；建立良好護病關係，鼓勵個案表達肢體截肢後內心想法，提供符合個案需求自製衛教手冊，以便返家後傷口照護及出院後復健規劃，希冀藉此護理經驗分享及探討內容作為日後醫護人員於照顧相關個案之照護指引。

關鍵字

燒燙傷護理；截肢；自我照顧技巧；焦慮

並列摘要

This article describes a 65-year-old woman living alone who suffered burns and scalds covering 30% of her upper limbs and chest. From March 13th to April 16^(th) of 2020, a holistic assessment of the four levels of physical, psychological, spiritual and social was carried out, and identified health problems including acute pain, loss of self-care ability and anxiety. Explanation of dressing change method during the care process, utilizes deep breathing relaxation techniques, bring along patient’s familiar items, and listen to music to distract from the pain. Inter-professional practice, strengthen physical training, use special adjustable utensils and bowl with suction cups on the bottoms or non-slip pads to facilitate self-eating, so the patient can increase self-care confidence; establish a good nurse-patient relationship; encourage the case to express thoughts after limb amputation, and provide custom-made health education manuals that meet the needs of the case to facilitate wound care after returning home and planning rehabilitation scheme following discharge.It is hoped that by sharing this nursing experience and discussion content, this case will be used as a care guide for medical staff in caring for related cases in the future.

並列關鍵字

burn injury treatment ； amputation ； self-care skills ； anxiety

參考文獻

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許華真、陳淑芳、徐琬茵、謝生蘭（2017）‧一位因石化氣爆燙傷病人之加護護理經驗‧高雄護理雜誌，34(1)，61-71。https://doi.org/10.6692/KJN-2017-34-1-6

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