一位長期皮膚搔癢之中風老人合併低自尊之護理經驗

A Nursing Experience of an Elderly Stroke Patients with Pruritus and Low Self-esteem

陳雅貞(Ya-Chen Chen) ； 余美蓮(Mei-Lien Yu)

《安泰醫護雜誌》 18卷1期 (2012/03) Pp. 47-58

https://doi.org/10.7078/TSMHMNJN.201203.0047

摘要

本文主要探討長期皮膚搔癢之中風老人合併低自尊之護理經驗，過程中運用關懷、傾聽、訪談及同理心等方式，收集主、客觀資料，針對個案身體、生理、心理及社會等方面作整體性評估，應用Gorden十一項功能性健康型態評估作為導引，確立主要健康問題：一、失眠，與皮膚乾癢、環境吵雜、刺眼的燈光有關。二、身體活動功能障礙，與左側肢體關節活動度受限制有關。三、潛在危險性皮膚完整性受損，與身體固定不動有關。四、低自尊，與左側偏癱導致長期活動受限、無法完成復健活動項目有關。在整個照護過程中，積極改善個案皮膚乾癢所帶來的生理不適外，並加強肢體復健活動及自我照顧能力，進而提升個案自尊；同時透過護病關係的建立，增加個案面對自身的疾病之正向態度，希望藉此照護經驗，能與護理同仁分享，以助提升日後照護此類病患之參考。

關鍵字

老年人 ； 皮膚搔癢 ； 低自尊

並列摘要

This paper presented a nursing experience of an elderly stroke patient with pruritus and low self-esteem. During his hospitalization, several measures were used for data collection and analysis, such as observation, conversation, physical examination and Gordon's 11 functional health patterns. Four issues were identified, including insomnia related to the dry and itching skin, noisy and the harsh light; impaired physical mobility related to the limitation of left side body joint; potential impairment of skin integrity related to the immobilization; and low sell-esteem related to the unable performing rehabilitation. After discussing with the patient and his family, a care plan was devised and implemented. The care plan was found to improve the uncomfortableness caused by the dry and itching skin, It also helped the patient to participate effectively in physical activity and self care. These interventions resulted in establishing good relationships between the patient and the nurse. Therefore, the patient had the courage and good attitude to handle or control himself. The author hopes that this case report may provide a reference for health professionals who are taking care of this type of patients.

並列關鍵字

elderly ； pruritus ； low self-esteem