運用鏡像治療於一位青少年因車禍意外導致下肢截肢之照護經驗

本文為一位青少年因車禍導致左小腿造成開放性骨折及部分殘肢分離接受截肢之照護經驗。筆者自2020年01月03日～01月25日照顧期間，運用Gordon十一項功能性健康型態評估作為指引。透過觀察、會談、傾聽、直接照顧評估及查閱病歷等方式收集資料，確立有急性疼痛、身體活動功能障礙及身體心像紊亂等健康問題。照護過程以主動關懷建立良好護病關係，運用疼痛控制技巧及鏡像治療減輕疼痛及幻肢痛；採漸進式復健運動維持肌力和關節活動度，提供輔具相關資訊，傾聽個案表達對身體外觀改變的感受以增強正向認知及自我價值，協助接受身體改變之事實促進個案重新建立自我角色功能與價值感，照會社工提供社會資源訊息，以利出院後重返家庭與社會，恢復獨立自我照顧功能，進而提升生活品質及社會適應。

關鍵字

截肢；急性疼痛；身體活動功能障礙；身體心像紊亂；鏡像治療

並列摘要

This case report was to share the experience of caring for a left below-knee amputated teenager, who suffered from left calf open fracture from traffic accident. By applying Gordon's 11 function health patterns assessment guide through observation, consultation and chart review acute pain, physical disabilities and psychological disruptions were identified as health problems. Meticulous care was taken to establish good nurse-patient relationship. By teaching various pain control techniques and mirror-method, I was able to help alleviate phantom pain. Via step-by-step rehabilitation, we were able to maintain muscle power and endurance, and joint range of motion. I supplied information on orthosis, and listened to patient's emotional distress on physiological deformity, helping him accept his new form. To assist him in returning to his family and rejoining the society, I focused on enhancing the patient's self esteem, positivity and self-worth. The ultimate goal was to help him recover the ability for self-care, to develop the skills for better life quality, and to eventually return to the society again.

並列關鍵字

Amputation ； Acute pain ； Decreased physical activity ； Body image disturbance ； Mirror therapy

參考文獻

何嘉莉、吳麗敏（2019）‧協助一位糖尿病血液透析病人面臨再次截肢後身體心像紊亂之護理經驗‧臺灣腎臟護理學會雜誌，18(1)，76-89。https://doi.org/10.3966/172674042019061801006

梁維安、王茹玉、林上英、陳月霞（2020）‧鏡像治療對手部神經損傷的治療效果-系統性回顧和統合分析‧物理治療，45(2)，160-161。https://doi.org/10.6215/FJPT.202006.P33.

陳威宏（2019）‧ERAS 術後多模式疼痛治療‧台灣醫學，23(2)，212-222。https://doi.org/10.6320/FJM.201903_23(2).0009.

Burden, N., Simpson, J., Murray, C., Overton, P. G., & Powell, P. A. (2018). Prosthesis use is associated with reduced physical self-disgust in limb amputees. Body Image, 27, 109-117. https://doi.org/10.1016/j.bodyim.2018.08.001

Luza, L. P., Ferreira, E. G., Minsky, R. C., Pires, G., & da Silva, R. (2020). Psychosocial and physical adjustments and prosthesis satisfaction in amputees: a systematic review of observational studies. Disability and Rehabilitation. Assistive Technology,15(5), 582-589. https://doi.org/10.1080/17483107.2019.1602853

國際替代計量

運用鏡像治療於一位青少年因車禍意外導致下肢截肢之照護經驗

全文下載

主題瀏覽