一位年輕病態性肥胖男子行腹腔鏡胃繞道減重手術之護理經驗

A Nursing Experience of a Young Morbidly Obese Man Who Underwent Laparoscopic Gastric Bypass Bariatric Surgery

林思懷(Szu-Huai Lin) ； 林春珍(Chun-Chen Lin)

《高雄護理雜誌》 38卷1期 (2021/04) Pp. 86-97

https://doi.org/10.6692/KJN.202104_38(1).0008

摘要

本文描述一位年輕病態性肥胖病患初次面對手術的焦慮及術後自我照顧的改變，成功適應且回復平日生活型態的護理經驗。於2018年1月2日至1月5日，運用Gordon十一項功能性健康評估，確認主要健康問題為焦慮、潛在危險性手術情境傷害及知識尋求行為。護理期間術前藉由傾聽、引導表達想法及壓力源，提供手術正確資訊及病友資源；術中運用專業知識執行正確擺位及手術標準流程預防潛在性傷害；術後共同閱讀文獻、會診營養師及個管師設計專屬飲食衛教指導手冊及單張，讓其主動參與學習自我照顧方法。建議未來照護模式協同營養師專業，對減重病患進行專人個案飲食管理並設置諮詢專線，提升持續性照護品質。

關鍵字

病態性肥胖 ； 腹腔鏡胃繞道手術 ； 手術全期護理

並列摘要

This article describes a young morbidly obese patient who initially faced surgical operation anxiety and postoperative self-care changes, but then successfully adapted and responded well to the daily life style of nursing experience. From January 2nd to January 5th 2018, three major health problems such as anxiety, potential hazard of surgical issue, and the action of understanding patient education were identified by using Gordon's eleven functional health assessment program. Nursing care was carried out during pre-operative, peri-operative and post-operative periods as follow: Firstly, listening and facilitating the patient to express feeling and stress; secondly, positioning with professional and standardized procedure to prevent potential hazard; and thirdly, via literature review and personalized patient education information designed by the consulting Nutritionist and weight-control case manager, encouraging the patient to learn self-care voluntarily. It is recommended that any future care model be combined with the hospital’s dietetic professional to conduct a special case diet management for weight-loss patients and set up a consultation line to improve the quality of continuous care.

並列關鍵字

morbid obesity ； laparoscopic gastric bypass surgery ； full-term care of surgery

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