學齡兒童骨折術後合併反覆清創導致身體心像改變之護理經驗

Nursing Experience of Postoperative Fractures in School-Age Children with Repeated Debridement Leading to Changes in Body Image

廖佩珊(Pei-shan Liao) ； 陳美如(Mei-Ju Chen)

《若瑟醫護雜誌》 15卷1期 (2021/07) Pp. 95-106

摘要

本文描述一位學齡期8歲兒童因車禍骨折術後合併反覆清創導致身體心像改變之護理經驗。護理期間2017年9月2日至10月31日，運用Gordon11項功能性健康評估為評估工具，透過訪談、病歷收集、觀察、傾聽及身體評估來收集資料，確立個案之問題有：急性疼痛、組織完整性受損、身體活動功能障礙、身體心像紊亂。於護理過程中，筆者依個案喜好，運用治療性遊戲方式於護理過程中，以觀賞卡通台及說故事書等技巧來分散注意力，減輕疼痛；提供適當傷口照護，以修復受損組織皮膚之完整性，並藉由醫療團隊的介入，利用個案喜好的食物、貼紙當作獎賞，鼓勵共同參與制定復健計畫，增強肢體肌力活動，並積極進行復健治療；運用建立信任護病關係與主動關懷個案，傾聽、陪伴、以同理心、接受的態度，鼓勵個案表達其情緒；但也希望透過個別性的護理問題與個案互動、陪伴，給予支持鼓勵，讓個案最終可接受身體外觀的改變，最終順利出院。

關鍵字

學齡期兒童 ； 急性疼痛 ； 傷口照護 ； 身體活動功能障礙 ； 身體心像紊亂

並列摘要

This article describes the nursing experience of a school-aged 8-year-old child who has undergone repeated debridement after a fracture in a car accident. During the nursing period from September 2 to October 31, 2017, 11 functional health assessments of Gordon were used as assessment tools. Data were collected through interviews, medical record collection, observation, listening, and physical assessment. The problems in establishing the case were: acute pain , Impaired tissue integrity, physical activity dysfunction, and physical mental disorders. In the nursing process, the author uses the therapeutic game method in the nursing process to distract attention and reduce pain by using techniques such as watching cartoon stations and storytelling, and providing appropriate wound care to repair damaged tissues Completeness, and with the intervention of the medical team, using the food and stickers preferred by the case as a reward, encourage joint participation in the formulation of rehabilitation programs, strengthen limb muscle activity, and actively perform rehabilitation treatment; use to build a trust-care relationship Caring for the case actively, listening, accompanying, empathizing and accepting, encourage the case to express its emotions; but also hope to interact with the case through individual care issues, accompany, and provide support and encouragement, so that the case can finally accept the body The changes were eventually discharged smoothly.

並列關鍵字

school-age children ； acute pain ； wound care ； physical activity dysfunction ； physical mind disturbance

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