- 期刊
一位因學校體罰導致橫紋肌溶解症青少年之照護經驗
A Nursing Experience of an Adolescent with School Corporal Punishment inducing Rhabdomyolysis
摘要
學校體罰與學童學習效果、身體安全與心理健康息息相關，造成橫紋肌溶解症是不應該發生且可以避免的。本文為一位因學校體罰導致橫紋肌溶解症青少年之照護經驗，護理期間為2018年9月9日至9月17日，藉傾聽、觀察、會談、整體性評估等方式收集資料，確立個案有「潛在危險性損傷」、「急性疼痛」、「危害性家庭因應能力」等健康問題，以主動關懷、同理心、尊重等技巧建立治療性信任關係，引導個案及家屬抒發對疾病之感受、體罰衝擊與重返校園的困境，提供個別性護理指導，運用口語化衛教橫紋肌溶解症知識；靜脈輸注生理食鹽水200 ml/hr補充水分，矯正體液酸鹼電解質平衡；給予口服止痛劑，運用冰敷、抬高肢體及舒適擺位；結合醫療團隊及與學校老師溝通回饋，強化個案與案母對體罰正確觀念與因應。學生－家長－老師對體罰及其產生的負面影響應有正確認識，理性溝通處理衝突，營造正向管教環境。希望藉此照護經驗分享，提供護理同仁日後照護類似個案之參考。
並列摘要
School corporal punishment is closely related to students' learning, physical safety and mental health. This article is a nursing experience for an adolescent with rhabdomyolysis caused by school corporal punishment during the period of nursing care from September 9^(th) to September 17^(th), 2018. Through personal medical data collection physical assessment, direct observation and interview records, three major health problems were identified as risk for injury, acute pain and compromised family coping. The author used the skills of active care, empathy and respect to establish a therapeutic trust relationship, then guided the patient and his family to express the impact of disease and corporal punishment and difficulty in returning to school. Individual nursing guidance was provided through knowledge of rhabdomyolysis to the patient. Medication wise, 200 ml/hr of 0.9% saline supplementation was used for intravenous infusion to hydrate and moderate electrolytes and acid-base balance of body fluids along with oral analgesics, ice compresses and raising the limbs to a comfortable position for assistance in pain reduction. The medical team acted in cooperation with the teachers to provide communication and feedback, and strengthen the correct concept of corporal punishment for the patient and his mother. It is recommended that schools should create a positive discipline environment where teachers and students should communicate rationally and effectively. This article provides a reference for nurses when dealing with similar diseases and situations.
參考文獻
延伸閱讀
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