- 期刊
運用Roy理論於一位腦中風復發合併吞嚥障礙之急性後期照護模式之護理經驗
Nursing Experience of Using Roy's Theory in the Acute Post-Care Model of a Stroke Recurrence Complicated with Dysphagia
摘要
本文為一位腦中風復發合併吞嚥障礙及第二級心臟衰竭個案，面對疾病及失能衝擊伴隨主要照顧者身心負荷之護理經驗。筆者於2019年3月24日至4月25日，運用羅氏適應模式評估，經由觀察、會談、身體評估及查閱病歷收集資料，確立健康問題為身體活動功能障礙、吞嚥障礙、無望感、照顧者角色緊張。照護期間與復健科團隊共同訂定復健計畫，提供急性期及急性後期照護模式合併心臟衰竭第二級運動訓練措施及長照資源；結合跨團隊醫療合作進行口腔主動運動、直接吞嚥訓練，教導正確進食步驟並成功移除鼻胃管；使用貝克無望感量表評估無望感、灌注希望及正向情緒支持以降低無望感；使用照顧者壓力量表評估，協助照顧人力資源重整以減輕照護者角色緊張。期望藉此護理經驗分享，作為日後照護參考。
並列摘要
This study investigated the impacts of the disease and disability on a patient with stroke, dysphagia and heart failure (NYHA Class II), and the related caregiver's physical and psychological burden. Through skills such as observation, interview, physical examination and review of medical records, the authors performed assessments based on Roy's Adaptation Model to determine health issues from March 24 to April 25, 2019. For the patient's physical disability, dysphagia, hopelessness and caregiver role strain, our department provided acute and post-acute care of a joint rehabilitation program with the rehabilitation team, Class II heart failure exercise training, and resources of long-term care to the patient and the family. Moreover, we developed an interdisciplinary team to facilitate the patient's active oral movement, perform direct swallowing training, provide instruction on correct dieting procedures, and smoothly remove the patient's nasopharyngeal (NG) tube. We also adopted the Beck Hopelessness Scale to evaluate the level of hopelessness of the patient so that we could provide positive emotional support to reduce their level of hopelessness. For the caregiver, we used a Caregiver Stress Scale to evaluate the severity of caregiver role strain, consequently helping reorganize resources and duties for the caregiver. The results of the study are expected to provide an appropriate reference for future nursing care on the same type of patients.
參考文獻
延伸閱讀
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