一位脊椎狹窄接受脊椎減壓固定術之病人護理經驗

Patient Care Experience in a Spinal Stenosis Undergoing Spinal Decompression

劉美玲(Mei-Ling Liu) ； 陳清貴(Ching-Kuei Chen) ； 黃麗霞(Li-Hsia Huang)

《若瑟醫護雜誌》 14卷1期 (2020/07) Pp. 110-122

摘要

本文是描寫一位79歲女性接受脊椎減壓固定術之護理經驗，照護期間為2018年5月29日至2018年6月10日，在護理過程中藉由直接護理、觀察、會談、身體評估、病歷查閱及病人返家後回診等方式收集相關資料，運用Gordon十一項功能性健康型態評估，確立病人主要的護理問題為：焦慮、急性疼痛、身體活動功能障礙等護理問題。過程中提供衛教資訊、共同參與醫療照護，藉由多媒體影像、照片來輔助說明，澄清病人及家屬對於手術相關之疑惑來減輕其焦慮；與醫師共同討論急性疼痛處置措施，以藥物、非藥物治療及正確翻身技巧、擺位等方式改善疼痛程度；藉由照會復健師並邀請病人及家屬共同參與擬訂復健計畫，執行肌力及關節運動訓練，運用「手術後運動執行確認表」作為評估復健計畫之成效及改善依據，幫助病人盡早恢復健康，進而改善獨立之日常生活；藉此護理經驗與護理同仁分享，並期望提供護理同仁未來照護此類病人之參考。

關鍵字

椎間盤護理 ； 脊椎狹窄 ； 焦慮

並列摘要

This article describes the nursing experience of a 79-year-old woman undergoing spinal decompression and fixation. The care period is from May 29, 2018 to June 10, 2018. Direct care, observation, interviews, and physical assessment are used during the nursing process. The medical records were collected and the patients returned to their homes to collect relevant information. Gordon's eleven functional health assessments were used to establish the main nursing problems of patients,including anxiety, acute pain, physical activity dysfunction,and other nursing problems. Provide medical information and participate in medical care during the process. We use multimedia images and photos to assist explanations, clarify the doubts of patients and their families about surgery-related problems to alleviate their anxiety. Discuss with doctors about acute pain management measures, drugs, non-drugs. Treatment and correct turning skills, positioning and other methods to relieve the degree of pain; by taking care of the rehabilitation staff and inviting patients and their families to participate in the development of rehabilitation plans, performing muscle strength and joint exercise training, using the ＂post-surgical exercise implementation confirmation form＂ as evaluate the effectiveness of the rehabilitation program and improve the basis for helping patients recover to health as soon as possible, thereby improving their independent daily life. This experience is shared with nursing colleagues and is expected to provide a reference for nursing colleagues to care for such patients in the future.

並列關鍵字

intervertebral disc care ； spinal stenosis ； anxiety

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