- 期刊
運用跨團隊模式照顧一位頸椎損傷個案脫離呼吸器之護理經驗
The Nursing Experience of Successful Weaning for a Patient with Cervical Spinal Cord Injury Using Multidisciplinary Team Approach
摘要
本文為一位頸椎損傷呼吸器脫離成功的個案，住院期間與家屬對病情治療計畫意見不同，發生爭執，故引發筆者撰寫動機。護理期間為2020年3月29日至6月19日，運用生、心、靈、社會層面為評估依據，透過身體評估、直接照護、觀察、筆談及查閱病歷收集資料，健康護理問題有呼吸器戒斷功能失常、焦慮與照顧者角色緊張。筆者針對個案護理問題擬定個別性照護計畫，藉跨團隊介入輔助照護個案生心理問題；以傾聽、陪伴及同理心了解個案與照顧者的衝突；衛教家屬相關輔助照護；透過心理支持強化個案的未來自我期許、降低焦慮，促使個案盡早脫離呼吸器。建議長期氣切個案，由語言治療師介入發音訓練，以提升個案返家後與他人的溝通。
並列摘要
This article describes the success of a patient of cervical spine injury with respirator detachment. During the hospitalization period, he and his family members had different opinions on the medical condition treatment plan, and disputes occurred, which triggered the author's motivation for writing this report. The nursing care period is from March 29 to June 19, 2020. Using the four dimensions of physical, psychological, social and cultural, and spiritual as the basis for evaluation, data were collect through physical assessment, direct care, observation, interviews, and medical records. The main health care issues identified were: dysfunctional ventilator weaning response, anxiety, and caregiver role strain. The author develops a personal care plan for patient care issues using cross-team intervention to assist in caring for patients' physiological and psychological problems; using listening, companionship and empathy to understand the conflict between the patient and the caregiver; teaching family members related auxiliary care; strengthen the individual's self-expectations for the future and reducing anxiety through psychological support; and encouraging the patient to leave the respirator as soon as possible. Finally, it is recommended that long-term tracheotomy cases should be assisted by speech training by a speech therapist to improve the communication between the case and others after returning home.
參考文獻
延伸閱讀
- 房巧瑜、張淑娟（2013）。協助一位頸椎損傷與呼吸器依賴病人返家照護之護理經驗。澄清醫護管理雜誌，9(1)，55-64。https://www.airitilibrary.com/Article/Detail?DocID=18136702-201301-201303260046-201303260046-55-64
- 林慧亭（2019）。一位頸椎損傷個案身心健康照護與復健護理經驗。新臺北護理期刊，21(1)，141-148。https://doi.org/10.6540/NTJN.201903_21(1).0013
- 林伶黛、陳香蘭（2009）。照顧一位第二頸椎損傷個案使用頸椎外固定器之護理經驗。新臺北護理期刊，11(1)，93-102。https://doi.org/10.6540/NTJN.2009.1.010
- 李嘉綺、陳筱瑀、吳姿蓉（2012）。運用超連結系統理論於一位壯年期不完全性頸髓損傷個案重返職場之護理經驗。長庚護理，23(2)，268-275。https://doi.org/10.6386/CGN.201206_23(2).0014
- 歐雅琪、何慧敏、廖淑貞、王麒嘉（2016）。Nursing Experience of Caring a Patient Who Suffered Near-drowning with Successfully Weaned form Ventilator in the Intensive Care Unit。若瑟醫護雜誌，10(1)，99-114。https://www.airitilibrary.com/Article/Detail?DocID=1819026x-201607-201608100011-201608100011-99-114