重建腦中風病患身體心像之護理經驗

本文敘述照護一位46歲職場女性，初次腦中風後無法接受身體功能及外觀改變，而表現出負向行為情緒之護理經驗。個案於住院期間筆者運用觀察、會談及身體評估技巧，收集個案相關健康資料，依照Gordon十一項健康功能型態加以分析整理，發現個案之主要問題為身體活動功能障礙、身體心像紊亂、知識缺失、潛在危險性創傷-跌倒。藉由直接照顧個案身體功能缺失的過程中，以主動關懷、同理心及接受等支持技巧與個案建立良好護病關係，並運用跨領域醫護團隊合作模式擬定個別性及適切性照護計畫，協助個案面對疾病所致的身體外觀及功能改變所造成的心理衝擊，鼓勵表達內心感受及主動參與自我照顧計畫，適時提供疾病相關訊息以減少個案之不確定感，以建立正向自我概念及增強疾病照護認知，使個案能重新適應日常生活的自我照顧及促使早日恢復常態生活，筆者冀望藉此護理經驗，能提供作為日後照顧類似病患之參考。（志為護理，2012；11：3，87－98）

關鍵字

腦中風；復健；身體心像紊亂

並列摘要

This article described a nursing experience of a 46-year-old career woman who could not accept the changes in bodily functions and appearances after suffering a stroke, and manifested negative emotional behaviors. The author collected the patient's health information using observation, conversation and physical assessment skills. After analyzing the data using Gordon 11 item Functional Health Pattern Assessment, the author found 4 major health problems related to this patient, including: impairment of physical mobility, body image disturbance, knowledge deficit, and potential risk of injury (i.e. falling down). Through the process of direct nursing care of the patient's bodily function deficit, the author uses nursing support skills including active care, empathy and acceptance and developed a positive nurse-patient relationship, and applied interdisciplinary medical/nursing team to draft a individualized and appropriate nursing plan to further assist the patient in facing psychological impact resulted from the disease-induced changes in bodily appearances and functions, encouraging the patient to express her emotions and actively participate in self care plan. Also, the author provided disease related information and reduce the uncertainty of the patient in order to establish a positive self-perception and enhance disease care knowledge, to enable the patient to readjust to the self care in daily life and return to normal life. The author wished to provide the nursing experience as reference for future care of similar patients. (Tzu Chi Nursing Journal, 2012; 11:3, 87-98)

並列關鍵字

body image disturbance ； rehabilitation ； stroke

被引用紀錄

張書瑜（2015）。一位產後突發顱內出血經產婦之護理經驗。助產雜誌，(57)，80-91。https://doi.org/10.6518/TJOM.2015.57.8

蔡惠如、曾詩蘋、王守玉、張瑛瑛、趙玉環（2016）。探討首次腦中風病人初期之調適過程。護理雜誌，63(2)，103-112。https://doi.org/10.6224/JN.63.2.103

王惠萍、楊建中、徐秀琹（2018）。中風復原期病人復原力及其相關因素之探討。護理雜誌，65(5)，56-67。https://doi.org/10.6224/JN.201810_65(5).08

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重建腦中風病患身體心像之護理經驗

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