- 期刊
一位角膜潰瘍個案行多次全層角膜移植手術之照護經驗
Experience of Caring a Patient with Corneal Ulcer Underwent Multiple Surgeries of Penetrating Keratoplasty
摘要
本文為一位64歲女性，診斷角膜潰瘍於八年內行全層角膜移植手術四次皆失敗，本次入院行第五及第六次全層角膜移植手術之照護經驗。護理期間自2021年4月6日至5月15日，以會談、身體評估、直接照護、病歷查閱等方式收集資料，運用戈登十一項健康功能型態進行評估，確認個案有視覺感覺及知覺紊亂、知識缺失及無望感之健康問題。經調整自我照護技巧，預防視力受損造成之傷害，並增加個案對疾病預後差的認知，運用宗教介入，協助以正向態度接納疾病，降低無望感。建議可成立角膜移植個案管理師，及早介入病程，提供持續且完整的照護品質。期望透過此經驗分享，提供照護相關個案之參考。
並列摘要
This article concerns a 64-year-old woman who was diagnosed with corneal ulcer, and had subsequently undergoing four failed penetrating keratoplasties in eight years. She was admitted to the hospital for her fifth and sixth penetrating keratoplasty operations. During the nursing period-April 6 to May 15, 2021-Gordon's 11 functional health patterns were used for interviews, physical assessment, direct care, and medical record review. The observed symptoms included health problems related to disturbed sensory perception with specified visual perception, knowledge deficit, and sense of hopelessness. By improving the patient's self-care skills, it's possible to prevent accidental damage caused by visual impairment in one eye. Therefore, the author used health education, knowledge of penetrating keratoplasty operation, focused on self-care skills to help the patient understand the poor disease prognosis. Further, a religious intervention, such as meditation and chanting sutra, was used to help improve disease acceptance and reduce the sense of hopelessness. It is suggested that relevant professional groups appoint corneal transplant case managers to intervene in the course of the disease in a timely manner and carefully track the situation, so as to provide continuous and comprehensive care. The author hopes that the sharing of this nursing experience will provide a reference for similar cases.