一位腦中風失能併類天疱瘡個案之居家護理經驗

Home Care of a Stroke Patient with Disability and Bullous Pemphigoid

曾玉卿(Yu-Ching Tseng) ； 賴淑貞(Shu-Chen Lai) ； 陳淑暖(Shu-Nuen Chen)

《長期照護雜誌》 17卷2期 (2013/08) Pp. 185-195

https://doi.org/10.6317/LTC.201308_17(2).0009

摘要

本篇旨在描述一位腦中風失能併類天疱瘡個案之居家經驗。護理期間自2010年12月25日至2011年4月1日，共家訪7次及電訪6次，運用身體評估、觀察及會談等技巧，將個案資料及照顧者照顧情況，利用Gordon十一項健康功能評估，分析結果發現有現存性危險性感染、現存性皮膚完整性受損、身體活動功能障礙、壓力負荷過重（家屬）等健康問題。經由教導管路留置照護、膀胱功能訓練等護理措施，使能正確執行管路照護繼而順利拔除尿管；教導正確執行傷口護理技巧及調整自製飲食以促進傷口癒合，皮膚受損處再無感染發生；給予日常生活照護指導及提供正向回饋讓個案產生復建的意願，並有效維持其健側肢體的功能；教導居家照顧相關認知、管路照顧技巧及提供支持團體及專業人員介入後，有效降低家屬壓力情緒（壓力自我檢測表由17分降到8分）。期望藉此護理經驗提供日後居家照護之參考，進而達到高品質的照護功能。

關鍵字

腦中風 ； 類天疱瘡 ； 壓力負荷

並列摘要

This report described a home nursing care experience of a disabled patient with stroke and bullous pemphigoid. The home nursing care was from 12/25/2010-4/1/2011, including 7 home visits and 6 telephone interviews. Based on Gordon 11-item Healthy Assessment, we evaluated the condition of this patient and his caregivers by using skills of physical evaluation, observation, and conversation. Health problems such as existing infection risk, impaired skin integrity, barrier of physical activity and caregiver burden were revealed by analysis. The urinary catheter was cared properly and then removed smoothly after teaching how to care and bladder training. After proper wound-care teaching and adjustment of homemade diet to promote wound healing, no more infection happened over impaired skin. We not only provided daily life care guidance but gave the patient positive feedback of rehabilitation to maintain the function of intact side. After teaching conceptions of the home care, catheters care, and rehabilitation skills; and providing the referrals of supporting groups and professionals, stress of family members was effectively lessened (Stree Self Test from 17 to 8). We look forward to improving the quality of home nursing care by providing this experience.

並列關鍵字

stroke ； bullous pemphigoid ； caregiver burden