一位肢障患者長期使用呼吸器之脫離經驗

Nursing Experience in Weaning a Disabled Patient from Long Term Mechanical Ventilation

莊雅婷(Ya-Ting Chuang) ； 白玉珠(Yu-Chu Pai)

《慈濟護理雜誌》 2卷4期 (2003/12) Pp. 95-104

https://doi.org/10.6974/TCNJb.200312.0095

摘要

本文敘述一位40歲天生肢障患者，因無法脫離呼吸器致活動受限連續51天無法下床，身心倍受壓力與煎熬，經筆者運用Orem理論進行全面性評估，確立個案有：呼吸器戒斷反應功能失常、身體活動功能障礙及個人因應能力失調等健康問題，筆者依照Orem的護理理論基礎，提供個案於呼吸器脫離過程中所需之個別性護理活動，協助其達到自我照顧的最終目標。在醫療團隊16天之努力下個案成功的脫離呼吸器，護理過程中藉由加強訓練其肢體功能，個案最後再度站起來並帶著信心與希望重回職場。故筆者提出此一護理經驗及心得，以作為臨床上護理人員協助肢障病人脫離呼吸器，及提升該類病患自我照顧能力之參考。

關鍵字

肢障 ； 脫離 ； 呼吸器 ； 歐倫理論

並列摘要

The researcher presented a 40-year-old patient, who was congenitally physically-disabled. After an operation, he was ventilator dependent for consecutive 51 days, resulting in bed ridden, physically restricted, and mentally stressed conditions. Adapting the Orem’s theory as the structures of full spectrum of evaluations including physical examination, clinical observation and peer interviewing, the investigator concluded the patient suffered from four nursing problems as follows: 1.Ventilator weaning response-dysfunctional. 2. Mobility-impaired physically. 3. Coping – ineffective individual. Based on the supporting system from Orem theory, individualized nursing care was provided to achieve the goal of patient’s self-care during the weaning process. The ventilator was successfully weaned 16 days later after the process initiated by the medical team. In addition, through the continued nursing care, the patient was able to strengthen his physical condition and return to his work place with confidence and hope. This article may provide valuable experience of nursing care to help the physically-disabled patients wean ventilator and regain self-care ability.

並列關鍵字

disabled ； weaning ； mechanical ventilator ； Orem's theory