運用急性後期照顧於獨居腦中風個案照護經驗

本篇係探討運用急性後期照顧於一位70歲獨居腦中風個案，因第二次梗塞性腦中風導致其左側偏癱及焦慮之護理經驗。照護期間2018年3月03日至4月02日止，筆者運用Gordon十一項健康功能進行評估，藉由觀察、評估、會談及病程紀錄收集、分析資料，確立個案的健康問題為：身體活動功能障礙、自我照顧能力缺失及焦慮。在與個案建立良好治療性人際關係後，透過傾聽、關懷給予個案正向支持，轉介急性後期專業團隊協助與合作下，協助個案與案弟共同面對問題，訂定護理計畫提供適當照護，運用急性後期照護（Post-Acute Care, PAC）每週五天每天三次之高強度復健幫助個案減少身體活動障礙，進而增進自我照顧能力，改善害怕被遺棄及失能之焦慮，轉介出院準備服務小組，運用長照2.0及實物銀行資源，幫助個案出院後獲得持續性照顧，恢復最佳肢體功能，提升生活品質避免合併症。期望藉此經驗分享，能提供護理人員對於獨居腦中風個案之照護上的參考，建議護理人員能更了解及運用急性後期團隊照顧方式與長照資源內容，使個案獲得無縫接軌照顧。

關鍵字

急性後期照護；腦中風；焦慮；長照

並列摘要

This article discusses the nursing experience of using post-acute care for a living alone 70 years old second stroke patient with left hemiplegia and anxiety. The care period was from March 3 to April 2, 2018, The author used Gordon’s health function to collection and analysis information by the observation, evaluation, interviews, and of medical records than identified the patient care problems including physical activity dysfunction, lack of self-care ability and anxiety. In addition to providing the post-acute care three times of day high-intensity rehabilitation to reduce physical activity disorders, thereby improving self-care ability, improving anxiety about fear of being abandoned and disability, referral to discharge preparation. The service team using long term care and physical banking resources to help patients get continuous care after discharge, promote limb function, improve of life quality and complications. We share the experience for taking care of this patients in the future. We hope this nursing experience could benefit post-acute care of long term care resource, up to standard seamless integration.