- 期刊
一位創傷性頸椎損傷患者之加護經驗
A Nurse's Experience of Intensive Care for a Patient with Traumatic Spinal Cord Injury
摘要
本文為一位由高處墜落導致第五頸椎損傷併下半身癱瘓患者之護理經驗。照護期間為2017年5月10日至5月26日止，以Gordon十一項健康功能性評估、觀察、會談及身體檢查等方式收集資料，確立患者有低效性呼吸型態、身體活動功能障礙及無望感等健康問題。照護期間筆者與患者建立信任護病關係，提供跨團隊專業照護，除了於創傷急性期維持呼吸道暢通，並鼓勵患者和家屬共同擬定治療計畫，參與規律肺部訓練及四肢肌力復健活動，引導患者表達內心疑慮與負向情緒，使患者重拾對生活之控制力及自信心，度過無望感的過程。建議未來照護此類患者時，於入院時即開始啟動出院準備服務計畫，並使用簡式健康量表初步篩檢心理需求，確實提供心理關懷及評估返家照顧及輔具之需求，以維護全人的專業護理照護品質。
並列摘要
This article describes the nursing experience of a fifth cervical spine injury and a lower body paralysis patient due to falling downstairs. Gordon's 11 Function Health Patterns were applied to evaluate the patient's health status. The main nursing problems were identified as ineffective breathing pattern, impaired physical mobility and hopelessness. During the acute-intensive stage of spinal injury, the patient's respiratory pattern was improved through use of mechanical ventilators with endotracheal intubation, oxygen therapy and chest physiotherapy. The author also arranged interdisciplinary care and encouraged the patient and his family to actively participate in decision-making about his own treatment plan and rehabilitation exercise while guiding him to express feelings of hopelessness and negative emotions in order to allow the patient to regain self-control over his life and confidence in reconstruction to overcome these dilemmas. We hope that relevant nursing staff would also provide comprehensive nursing care for physical and psychological needs of patients through the implementation of early discharge plans and assessment of psychological symptoms. The study is expected to provide a reference for a holistic care of a patient with spinal cord injury.
參考文獻
延伸閱讀
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