一位脊髓損傷患者行脊髓電刺激手術之照護經驗

本文敘述一位23歲高位脊髓損傷男性，經由長期復健治療後，仍有下半身乏力、神經性疼痛等症狀，進而入院行脊髓電刺激手術。照護期間自2019年9月16日至11月06日。筆者依據Gordon十一項功能性健康型態評估，藉由與個案會談、觀察、身體評估與病歷查閱等方式進行資料收集與分析，確立個案面臨之健康問題有疼痛、身體活動功能障礙及焦慮。在照護期間協助進行復健活動訓練，如：紅繩懸吊運動訓練、傾斜床站立以及電子式阻力腳踏車，維持身體活動功能及肌肉強度；利用疼痛量表評估個案疼痛程度，指導個案利用非藥物處置緩解疼痛；並運用同理心引導個案能夠藉由表達內心的害怕來減少焦慮。期望藉此護理經驗提供於日後護理人員臨床照護類似個案之參考。

關鍵字

脊髓損傷；脊髓電刺激手術；疼痛；身體活動功能障礙；焦慮

並列摘要

This article reports on the nursing experience in caring for a 23 year old man who suffered a spinal cord injury after a car accident. Even after long-term rehabilitation therapy, the patient felt weakness in his lower limbs and neuralgia. Therefore, he was admitted in our hospital for spinal cord stimulation surgery. Nursing care for the patient lasted from September 16 to November 06, 2019. Gordon's functional health patterns assessment, pen-and-paper communication, systematic observation, as well as the medical records were utilized for data collection. According to the results of the data analysis, major health problems encountered by the nurse included pain, impaired physical mobility, and anxiety. During care, the patient's level of pain was assessed via the pain scale, and subsequently the patient and family were instructed to utilize relaxation techniques, massages, and medication. Rehabilitation activities were arranged for muscle strength training, such as the use of Redcord training and tilting a table at 65 degrees for 20-30 mins to maintain the patient's physical activity and enhance muscle strength. We provided active, caring companionship, guided the patient to express his inner feelings, enhanced his positive self-concept to help him actively cooperate with the rehabilitation. We hope that this nursing experience can serve as a future reference for nursing staff with similar cases.

並列關鍵字

anxiety ； impaired physical mobility ； pain ； spinal cord injury ； spinal cord stimulation

參考文獻

Finnerup, N. B. (2019). Nonnarcotic methods of pain management. New England Journal of Medicine, 380(25), 2440-2448. https://doi.org/ 10.1056/NEJMra1807061。

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