一位青少年因多重外傷導致身體心像紊亂之照顧經驗

Nursing Experience of an Adolescent with Body Image Disturbance Due to Multiple Trauma

楊千慧(Chien-Hui Yang)

《高雄護理雜誌》 27卷1期 (2010/05) Pp. 49-59

https://doi.org/10.6692/KJN-2010-27-1-5

摘要

本報告旨在呈現一位多重外傷青少年的病患，因神經功能受損住加護病房之護理經驗。筆者自96年12月5日至12月16日護理期間，運用Gordon十一項健康型態功能評估作為指引，運用觀察、會談及傾聽之技巧收集相關資料，確立個案有身體心像紊亂、顱內調適能力降低、呼吸道清除功能失效、潛在危險性廢用症候群等護理問題。護理過程中運用主動關懷、同理心及接受等支持技巧與個案建立良好護病關係，取得家屬的支持配合，共同協助個案接受暫時外觀改變的事實，重建正向之自我概念，逐漸減少對家屬之依賴，並衛教出院後對多重外傷之注意事項，使個案出院能重新適應日常生活的自我照顧，筆者冀望藉此護理經驗，能提供作為日後照顧類似病患之參考。

關鍵字

多重外傷 ； 青少年期 ； 身體心像紊亂

並列摘要

This article describes the nursing experience with an adolescent with head damage due to multiple traumata in an intensive care unit. Care, the Gordon's 11 functional nursing assessments framework, was used to assess the adolescent. Data were collected through direct care, physical examination, observations and interview etc. The adolescent was identified as having five nursing problems, including disturbed body image, intracranial adaptive incapacity, ineffective airway clearance and risk for disuse syndrome. The caring intervention included providing active sympathy; accepting the patient's condition, establishing a good patient-nurse relationship, while encouraging the subject to face the reality of a temporary change of the body and helping him and fellow patient members in the unit perform rehabilitation together. In addition, reestablishment of positive self-concept to reduce dependence, and care about multiple traumatic injuries after discharge were also provided, to assist the patient in re-adjusting to daily life. The nursing experience provided a useful reference for caring for similar patients with multiple traumatic injuries.

並列關鍵字

multiple injury ； adolescent ； body image disturbance