照護一位再發性腦中風老年病人的護理經驗

Caring for a Patient with Recurrent Stroke

劉瓊珠(Chiung-Chu Liu) ； 李英芬(In-Fun Li)

《馬偕護理雜誌》 3卷1期 (2009/01) Pp. 85-94

https://doi.org/10.29415/JMKN.200901_3(1).0009

摘要

腦中風是老年人常見的疾病，也是造成日後生理殘障的主因。本報告敘述如何照顧一位一年內發生三度中風合併左側無力的病人，因身體活動功能障礙，產生焦慮、想放棄復健到願意復健的護理過程。筆者於照護期間藉由觀察、訪談及應用Gorden十一項功能性健康評估等技巧收集資料、確認問題。發現個案主要的護理問題有：身體活動功能障礙、自我照顧能力缺失、疾病認知缺失及焦慮。經由主動關懷、傾聽個案需求及陪伴，給予護理指導，及透過與個案及家屬共同討論設計復建運動計畫，協助病人緩解情緒困擾，使其願意在家屬陪伴下持續復建運動，逐漸恢復肢體活動功能。藉此個案經驗分享，提供臨床護理人員在往後照顧類似病患時，能更容易針對病人護理問題，給予最實際的幫助，協助病人早日回到過去的生活並能持續的復健，提高日後居家自我照顧的能力。

關鍵字

腦中風 ； 復健 ； 老年人

並列摘要

Cerebral vascular disease is one of the commonest illnesses seen in the elderly and is one of the main causes of physical handicap in this age group. A patient had three strokes causing left-sided weakness within one year. The author collected information and assessed the problems through observation, interviewing, and use of Gordon's functional health assessment. The major nursing problems confronting this patient were the physical disabilities, an inability to perform self care, lack of knowledge about the condition, and anxiety. The goals of individualization and integrity were addressed through active caring; listening to the patient's needs; designing the rehabilitation program in discussion with the patient and family, as well as accompanying the patient to therapy; assisting the patient with emotional distraction; and helping family members carry on with the rehabilitation program. If nurses understand patients' conditions, needs, and attitudes by going through the first steps of rehabilitation with them, they are better able to provide appropriate practical help, ultimately increasing patients' ability to care for themselves.

並列關鍵字

stroke ； rehabilitation ； elderly