一位自殺導致食道灼傷老年患者身心適應之護理經驗

本文旨在探討一位喝通樂自殺導致食道灼傷的老年患者，術後進行身心適應的護理過程。筆者在2007年10月12日至2007年10月27日護理期間，透過觀察、訪談、傾聽、身體評估等方式完成資料收集，於照護過程中，依所面臨的生理和心理問題，依據Gorden十一項健康功能評估加以確立問題及目標，發現個案有呼吸道清除功能失效、無望感及個人因應能力失調等護理問題。護理的重點，在心理方面，個案因與家人溝通不良的問題導致自殺，自殺術後又因身體功能衰退而產生無望，故筆者以主動關心、運用同理、尋求家人支持及提供醫療資源等方式，並運用文獻所提的希望感建立技巧及壓力評價因應概念，以協助個案與他人互動、降低無望，進而願意參與自我照顧，並採計畫性的呼吸器脫離訓練，使個案最終能脫離呼吸器。最後，再教導個案正向的因應技巧，使個案在住院過程中能獲得心靈的平靜，肯定自我價值，並調適疾病過程的變化，降低再自殺的想法。

關鍵字

自殺；食道灼傷；老年患者；無望感；個人因應能力失調

並列摘要

An elderly woman had tried to commit suicide by ingesting poison, sustaining corrosive injury to the esophagus that required surgery. The author cared for the patient for 10 days postoperatively, providing physical and psychological care. Data was collected through observation, interview, listening, and physical assessment. The problems identified according to Gordon 11 functional health assessment included ineffective airway clearance, hopelessness, and ineffective individual coping. The psychological assessment revealed that poor communication with family members had led the patient to attempt suicide, and the postoperative physical dysfunction generated a sense of hopelessness. The author displayed active concern and empathy, helped to find family support, and offered the patient medical resources. Based on methods in the literature, the author helped the patient to reestablish a sense of hope, increase her interaction with others, and participated in self-care. The author successfully assisted the patient through the process of weaning from the ventilator, as well as teaching the patient the positive skills of stress appraisal and coping. During hospitalization, the patient was able to remain calm, develop an enhanced sense of self-worth, adapt to her physical condition, and decrease recurrent suicidal thoughts.

並列關鍵字

suicide ； esophageal corrosive injury ； elderly patient ； hopelessness ； ineffective individual coping

國際替代計量

一位自殺導致食道灼傷老年患者身心適應之護理經驗

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