一位中年男性腦中風併失語症病人之護理經驗

Nursing Care Experience of a Relatively Young Stroke Patient with Aphasia

蔡玉梅(Yu-Mei Tsai) ； 陳麗雪(Li-Hsueh Chen)

《馬偕護理雜誌》 12卷1期 (2018/01) Pp. 59-70

https://doi.org/10.29415/JMKN.201801_12(1).0005

摘要

本文描述一位中年男性，因腦中風導致肢體活動障礙併有表達性失語症，而導致肢體活動及溝通障礙，因無法接受身體功能改變的打擊，出現無望感等情緒之護理經驗。於2016年6月16日至2016年7月11日藉由會談、傾聽、觀察等方式收集資料，運用Gordon十一項功能性健康評估，確立病人有身體活動功能障礙、自我照顧能力缺失、言詞溝通障礙及無望感之健康問題。在身體活動功能障礙方面：透過跨團隊的合作模式，安排個別性復健計畫，增加肢體活動能力；在自我照顧能力缺失方面：指導日常生活照護技巧而降低依賴程度，加強自信心；在言詞溝通障礙方面：運用替代性溝通輔具，強化病人的溝通能力，創造友好的溝通環境；在無望感方面：協助認清其所面臨的壓力情境，以同理關懷態度給予正向的鼓勵，有效增進病人自我控制感，協助度過無望感的危機。建議建立腦中風復健居家服務，以持續追蹤病人返家復健活動狀況，協助對重返職場做準備，使腦中風病人保有最佳的生活品質，期望藉此經驗分享，以提供日後護理人員照護之護理參考。

關鍵字

腦中風 ； 失語症 ； 無望感

並列摘要

This article described the nursing care experience of a relatively young stroke male patient who suffers from impaired physical mobility and a complication of aphasia. Frustrations and dependency about function loss were observed due to this patient’s inability to accept physical and language changes. Nursing care period was from June 16 to July 11, 2016; both subjective and objective data were collected through interview, listening, and observation, according to Gordon's eleven functional health patterns assessment tool. Significant health problems were revealed to include impaired physical mobility, self-care deficit, impaired verbal communication, and most importantly hopelessness. Nursing interventions were executed through cross-team cooperation with physical therapy to increase physical activity, strengthen self-confidence for self-care deficit. increase communication ability, give positive encouragement and enhance self-control for get through the crisis of hopelessness. Lessons were learned from this case to establish a rehabilitation home service to follow-up stroke patient after discharge and facilitate their return to the family and work community.

並列關鍵字

brain stroke ； aphasia ； hopelessness