照護一位雙側人工髖關節置換術個案之護理經驗

Nursing Care after Bilateral Total Hip Replacement

羅淑芬(Shu-Fen Lo) ； 康瑞蘭(Jui-Lan Kang) ； 呂惠珠(Hui-Chu Lu)

《馬偕護理雜誌》 3卷1期 (2009/01) Pp. 74-84

https://doi.org/10.29415/JMKN.200901_3(1).0008

摘要

本文為照護一位因長期酗酒導致雙側股骨頭壞死，接受雙側人工髖關節置換手術個案的護理經驗。在照護期間，運用觀察、會談、傾聽、查閱病歷等方式收集資料，以Gordon十一項功能性健康模式做整體性評估，確認個案的主要護理問題有焦慮、疼痛、身體活動障礙、性生活型態改變等，經由介入以下護理措施：以多媒體影音光碟及衛教手冊進行人工髖關節置換術之護理指導，及以呼吸放鬆技巧等來減輕焦慮；使用芳香療法及不具黏性之敷料，來改善傷口疼痛；以口語化及簡明的方式說明計劃性復健運動之重要，並讓個案反覆練習，使個案能克服身體活動障礙，逐漸恢復日常生活的活動功能；提供性姿勢的圖片作為輔助工具，協助個案性生活的調適，以增進手術後的適應，經由以上措施已解決個案之護理問題，使個案達到最佳的復原狀態。

關鍵字

人工髖關節置換術 ； 多媒體影音光碟 ； 焦慮

並列摘要

The nursing care for a patient with alcoholism who had bilateral femur head necrosis and underwent bilateral total hip replacement is described. During the nursing period, information was collected by observation, conversation, listening, and chart review. We evaluated the patient using Gordon's functional health scale. The most obvious problems during hospitalization were anxiety, pain, impaired physical activity, and concern about limitations on sexual activity after the hip replacement. Nursing intervention included education of the patient in postoperative care of the surgical site; this was accomplished using a teaching manual and multimedia CD-ROM and in instruction of the use of deep breath skills to relax. Aromatherapy and a non-adhesive dressing were used in wound care to decrease pain. The patient was briefly instructed about the importance of rehabilitation after surgery and the need to persist in prescribed exercise to overcome limitations in physical activity. To relieve concern about sexual activity, we supplied pictures of sexual positions that would not adversely affect the artificial hip joints. As a result of the nursing care, his physical problems and emotional concerns were resolved.

並列關鍵字

total hip replacement ； multimedia ； anxiety