運用羅氏理論於一位角膜潰瘍行眼球摘除個案之護理經驗

The Nursing Experience of Using the Roy Theory in a Case of Ophthalmectomy due to Corneal Ulceration

陳佳莉(Chia-Li Chen) ； 黃琬惠(Wan-Hui Huang) ； 陳素月(Su-Yueh Chen)

《安泰醫護雜誌》 20卷2期 (2014/12) Pp. 12-24

摘要

本文敘述一位因角膜潰瘍導致角膜穿孔，而施行眼球摘除手術的護理經驗。護理期間從2010年8月6日至2010年9月10日，透過直接照護、觀察及會談等方式收集主觀、客觀資料，並分析歸納出個案因施行眼球摘除術，對其造成的主要護理問題有：焦慮、急性疼痛／與手術後傷口有關、感覺知覺改變／視覺、身體心像紊亂／與身體外觀改變有關。護理過程中筆者運用主動關懷、陪伴、傾聽、同理心等支持技巧，與個案及家屬建立良好的護病關係，鼓勵個案說出內心的感受，並運用Roy理論中之生理調適與心理調適概念，針對個案之護理問題，經由臨床實際照護提供適當的護理措施，使個案不適之症狀獲得緩解改善，並協助其手術後身心之調適，重建正向的自我概念，增強自我的自信心，提升自我的價值感。

關鍵字

角膜潰瘍 ； 眼球摘除術 ； 羅氏適應理論

並列摘要

This study describes the experience of nursing a patient with corneal ulceration and perforation, leading to ophthalmectomy. During the nursing period from August 6th to September 10th, 2010, via direct care, observation and interviews to collect subjective and objective data, as well as analysis, we can summarize that the main nursing problems of patients undergoing ophthalmectomy are the following: anxiety, acute pain/related to post-operative wound, changes in sensory perception/vision and body image disturbance/related to changes in the appearance. During the process of nursing, the author utilized proactive caring, accompanying, listening and empathy as supportive techniques and built a good relationship with the patient and the family. The author encouraged the patient to communicate inner feelings and employed the concept of physiological and psychological adjustments in the Roy Theory to provide adequate nursing through clinical care tailored for the patient's nursing problems and to soothe and improve the patient's discomfort. Furthermore, the patient was assisted in making adjustments in both physiology and psychology after the operation and in rebuilding a positive self-concept with enhanced self-confidence and an elevated sense of self-worth.

並列關鍵字

corneal ulceration ； ophthalmectomy ； Roy's Adaptation Theory