照顧一位骨折創傷後膝上截肢患者的護理經驗

A Nursing Experience of a Fractured Patient with Post-traumatic Above-knee Amputation

鄭佩芬(Pei-Fen Cheng) ； 柯貞如(Chen-Ju Ko)

《志為護理-慈濟護理雜誌》 11卷3期 (2012/06) Pp. 119-128

https://doi.org/10.6974/TCNJ.201206.0119

摘要

此篇個案報告描述一位骨折創傷後膝上截肢患者的護理經驗，於2010年4月2日至22日護理期間運用Gordon 十一項健康功能評估為基礎架構以身體評估、直接護理及會談方式收集資料，確立「現存/潛在危險性感染：傷口及侵入性管路，致身體第一道防線受損。」、「疼痛：與骨骼、肌肉及神經受損有關」與「身體心像改變：右下肢截肢及身體活動功能障礙」。筆者除了衛教疼痛、感染控制技巧及術後復健運動之外，更針對外觀的變化所帶來的身體心像改變與心理衝擊提供心理支持，鼓勵案妻及兒子參與，協助個案調整生活，重建自我角色功能與價值感，提高生活品質。（志為護理，2012；11：3，119－128）

關鍵字

骨折 ； 截肢 ； 身體心像改變

並列摘要

This report described the nursing experience of a fractured patient with post-traumatic above-knee amputation. In the nursing period from Apr. 2nd to 22th in 2010, the study was conducted with Gordon's 11 Functional Health Patterns serving as the framework, and the data were collected by means of physical health assessment, direct care, and interview. The results showed that the patient suffered from ”existing/potential risk of infection: wound and invasive tubes damaging the first defensive line of body”; ”pain: relating to the damage of skeleton, muscles and nerves” and ”change of body image: right lower-limb amputation and impaired physical mobility.” In addition to the techniques in pain and infection control, as well as postoperative rehabilitation exercise, the nurse also provided the patient with psychological supports to deal with body image alteration and subsequent psychological influences, encouraging the patient's wife and son to participate in this process to assist the patient in adjusting the lifestyle, reconstructing the patient's autonomous functions and sense of value, and enhancing the patient's quality of life. (Tzu Chi Nursing Journal, 2012; 11:3, 119-128)

並列關鍵字

amputation ； body image alteration ； fracture