照顧一位頭部創傷併長期臥床個案之居家護理經驗

Long-Term Home Nursing Care of a Bedridden Patient with Head Trauma

徐春花(Chan-Hua Hsu) ； 王境堪(Chang-Kan Wang) ； 張虹珠(Chang-Hung Chu)

《馬偕護理雜誌》 5卷2期 (2011/07) Pp. 80-88

https://doi.org/10.29415/JMKN.201107_5(2).0008

摘要

頭部創傷在意外事故中是致死及失能的主要原因，常伴隨殘廢及認知功能喪失，造成家庭負荷及家屬緊張和不安。本文運用家庭評估模式探討一位頭部創傷併長期臥床個案，照顧者於照護個案及適應突發狀況的調適過程與需求。護理期間為2007年9月5日至2008年1月4日，進行十一次家訪及十五次電訪。運用家庭及身體評估、會談等方式，確立有呼吸道清除功能失效、便秘、潛在危險性廢用症候群、照顧者角色緊張四項健康問題。過程中藉由衛教、回示教、並採主動積極的態度，讓照顧者了解並能正確執行護理措施，使個案降低肺部感染，維持良好排便型態及減緩廢用症候群發生。此外，運用開放性會談及傾聽技巧，鼓勵案母說出照護壓力及想法，除提升照顧者照護品質外，進而改善其生活品質。

關鍵字

頭部創傷 ； 居家護理 ； 照顧者

並列摘要

Head trauma is a major cause of death following accidents. Even if not fatal, head trauma may result in significant morbidity, including disability and loss of perception and cognitive ability. Beyond the effects on the patient are the burdens such an illness places on family members. The author provided home health care for a 28-year-old man who sustained accidental head trauma and was subsequently bedridden. Over a period of 4 months, the author made 11 home visits and 15 telephone visits, using the family appraisal model to assess the care requirements and the adjustment of the primary care giver. There were four main problems, including poor clearance of respiratory secretions, constipation, the potential for disuse syndrome, and the caregiver's anxiety. These issues were addressed by health education, teaching in response to the caregiver's level of understanding, and training the caregiver in the skills needed to provide good care for the patient. In addition, the author used open interviewing and active listening to encourage the caregiver to express her feelings and fears. This nursing intervention helped to lower the pressure on the caregiver, improving the quality of care rendered and the patient's physical status.

並列關鍵字

head trauma ； home care ； care giver