運用舒適理論照護一位主動脈剝離術後病人之護理經驗

Nursing Experience of Applying Comfort care a Patient Post Aortic Dissection Operation

謝明珊(Ming-Shan Shieh) ； 陳慧菁(Hui-Ching Chen) ； 施孟綾(Meng-Ling Shih)

《彰化護理》 28卷4期 (2021/12) Pp. 119-132

https://doi.org/10.6647/CN.202112_28(4).0014

摘要

本文為運用舒適理論照護一位主動脈剝離術後病人之護理經驗。因為主動脈剝離疾病行緊急手術，術後面臨生理不適、擔心病情進展，加上身處陌生且封閉的加護病房環境，產生害怕焦慮不安，引發筆者欲深入探討的動機。主要照護期間為2020年01月02日至01月10日，藉由會談、訪視、觀察、傾聽、身體評估、直接照護等方式，發現有急性疼痛、低效性呼吸型態、焦慮等問題。運用舒適護理緩解手術傷口疼痛與低效性呼吸型態，提供計劃性之呼吸訓練，協助個案執行心臟復健運動計畫，緩解病人生理上的不舒適，主動關懷、傾聽的治療性溝通與陪伴，會客時間親友的支持、護理治療前予充份解釋，緩解焦慮不安提升自在舒適，並強化個案正向思考及心靈寄託。建議未來可增設雙向視訊裝置、電視或收音機，以轉移注意力並緩解焦慮情緒，藉此個案經驗分享期許未來護理人員在臨床照護上之參考，以提升病人之照護品質。

關鍵字

主動脈剝離 ； 舒適理論 ； 心臟復健運動

並列摘要

This article describes the nursing experience of applying comfort care a patient post aortic dissection. The case who had fear and anxiety problems and was in an confined intensive care unit environment after the emergency operation. These problems motivated the authors to explore it. We helped her to solve the physiological and psychological problems with applying comfort care. During the nursing period between January 02 to January 10 in 2020, observations, interviews, conversations, listening, and physical assessment and direct nursing cares were used to gather information and assess the patient, including physical, emotional, intellectual, social, and spiritual well-being. The following health issues were identified: acute pain, breathing pattern, and anxiety. In between the process of nursing case, provided with performing cardiac rehabilitation plan, comfort nursing intervention to improve respiratory pattern, and relieve wound pain. In addition, adjusted meeting time elastically, accompanied by family, fully explain before treatment to reduce anxiety and elevate comfort. Furthermore, we suggest to install two-way video devices, view monitors, video for diverting patients' attention and relieving anxiety. This experience would shed light to be useful information for other nurse staffs caring patient with similar situation in the future.

並列關鍵字

aortic dissection ； comfort ； cardiac rehabilitation

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