- 期刊
照護一位腰椎術後引發格林－巴利症候群病人之加護經驗
Intensive Care Experience of a Patient with Guillain-Barré Syndrome after Lumbar Surgery
摘要
本文描述一位腰椎滑脫術後引發格林－巴利症候群（Guillain-Barre Syndrome）患者，因呼吸肌肉無力導致呼吸衰竭入住於加護病房插管治療，期間對疾病不熟悉及重複插管感到恐懼、焦慮和抑鬱。護理期間為2021年3月9日至2021年4月17日，經由個別性直接照護、觀察、肢體及筆談溝通等方式蒐集資料，並使用Gordon十一項健康功能型態評估表分析出個案主要健康問題為：低效性呼吸型態、身體活動功能障礙、焦慮。作者經由護病關係的建構，期間除了醫療團隊以藥物治療改善其自體免疫問題外，更主動與其它醫療團隊擬定個別性的呼吸及肢體訓練計畫，促使個案能恢復身體功能。另個案常表達因對疾病預後及健康狀況感到憂心，藉由陪伴、給予正向鼓勵方式和家庭支持功能，讓個案主動表達心中的感受，再經由個別性護理和成功個案的視聽教學，而我們更將個案復健活動進步數字化，讓個案對治療有正向的態度和信心，使個案保有身心復原的希望。
並列摘要
This article describes a patient with Guillain-Barre Syndrome after lumbar spondylolisthesis surgery who was admitted to the intensive care unit for intubation due to respiratory failure and respiratory muscle weakness. During this period, he was unfamiliar with the disease, had repeated intubation, fear, anxiety, and depression. The nursing period was from March 9 to April 17, 2021. Based on Gordon's 11Functional Health Patterns Assessment Model, the data was collected by individualized direct care, observation, physical and written communication and so on. The patient's health problems included inefficient breathing patterns, physical activity dysfunction, and anxiety. Through the development of the nursing-patient relationship during this period, in addition to improving the autoimmune problem with drug treatment, the medical team also took the initiative to formulate individual breathing and limb training plans with other medical teams to promote the recovery of body functions. Besides that, through companionship, positive encouragement, and family support to allow the patient to actively express his or her feelings, as the patient often expresses concern about the prognosis and health status of the disease. Through individualized care and audio-visual teaching of successful cases, we have further digitized the rehabilitation activities of the patient so that the patient has a positive attitude and confidence in the treatment for retaining both physical health and mental ambition.