協助一位呼吸衰竭氣切術後裝置發聲閥病患之居家護理經驗

A Home-Care Experience of a Respiratory Failure Patient with Passy-Muir Tracheostomy Speaking Valve

廖素娟(Su-Chuan Liao) ； 周莉莉(Lih-Lih Chou)

《志為護理-慈濟護理雜誌》 12卷3期 (2013/06) Pp. 102-109

摘要

本文旨在探討一位呼吸衰竭合併氣切留置的病患，病況穩定後，教導照護知識與技巧並提供氣切發聲閥協助言語溝通及使用長照社會資源之居家護理經驗。護理期間自2010年12月28日至2011年05月19日，透過居家訪視及電訪、實際觀察及身體評估收集主、客觀資料，並以Gordon十一項功能健康模式，評估其主要的護理問題有：呼吸道清除功能失效、言辭溝通障礙、家庭因應能力不足。筆者於居家護理服務期間，以同理、關懷、傾聽、陪伴等方式，教導主要照顧者居家用物準備及居家照護知識與技巧，藉由共同討論，提供疾病照護相關資訊，訂定裝置氣切發聲閥的計劃，主動連結長照中心及經濟的社會資源，進而提升病人照護品質。

關鍵字

呼吸衰竭 ； 氣切發聲閥 ； 居家護理

並列摘要

The article aimed at discussing the home care experience of a inpatient who went through tracheostomy due to respiratory failure and, after the condition stabilized, were taught on nursing knowledge and skills with the provision of Passy-Muir tracheostomy speaking valve to assist in speech communication and social resources for long term care. The nursing period lasted from December 28th, 2010 to May 19th, 2011. The author collected objective and subjective data through home visits, telephone interviews, observation and physical assessment, and employed Gordon 11 functional health patterns to assess the patient’s health. The primary nursing issues were established: ineffective airway clearance, impaired verbal communication and lack of family coping. The author taught the primary caregiver in home preparation and nursing knowledge and skills by employing empathy, care, listening and companionship during the care period, and raised the quality of care by engaging in joined discussion, providing information regarding disease care, drafting a plan for the attachment of tracheostomy speaking valve and actively arranging the assistance of long-term care center and available social and economical resources.

並列關鍵字

home care ； respiratory failure ； tracheostomy speaking valve