頭部創傷患者之護理經驗

Nursing Care for a Head Injured Patient

李佳紋(Chia-Wen Li)

《北市醫學雜誌》 5卷1期 (2008/02) Pp. 137-145

https://doi.org/10.6200/TCMJ.2008.5.1.15

摘要

本文旨在描述一位因車禍導致頭部創傷患者由加護病房轉入神經外科病房之護理經驗，以Gordon十一項健康功能型態為評估架構，採觀察、傾聽、會談及溝通方式蒐集資料，結果個案有：急性疼痛、睡眠型態紊亂及創傷壓力反應等護理問題。經由教導個案轉移注意力、肌肉按摩等護理措施減輕疼痛；提供促進睡眠的方式及鼓勵適當的體能活動，夜間睡眠能達到4小時；引導家屬持續性支持及陪伴等護理措施，協助個案渡過創傷後所面臨的身體、心理各方面的衝擊。

關鍵字

頭部創傷 ； 急性疼痛 ； 睡眠型態紊亂 ； 創傷壓力反應

並列摘要

In this study, we present our nursing experience in an intensive care unit (ICU) and an ordinary ward with a patient who had suffered a head injury in a traffic accident. On the basis of Gordon’s eleven types of health functions, we integrated bed side observation, listening, communication and interviews in order to evaluate the patient. The major problems presented by the patient included: (1) acute pain syndrome, (2) sleep pattern disturbance and (3) posttraumatic stress syndrome. The physical pain was relieved by attention transfer, and skeletal muscle massage. The duration of sleep was maintained at four hours by physiological feedback and adequate exercise before sleep, which provided a means of accelerating sleep and encouraging suitable exercise. Encouraging the patient to participate in the interactions, sharing and discussion that occurred during group activities ought to be the most effective non-medical treatment for post-traumatic stress syndrome.

並列關鍵字

head injury ； acute pain syndrome ； sleep pattern disturbance ； post-traumatic stress syndrome