照顧一位腦中風年輕個案面對無望感之護理經驗

Nursing Experience in Caring for a Young Patient With Stroke Dealing With His Feeling of Hopelessness

許家萍(Jia-Ping Shiu) ； 陳柔均(Jou-Chun Chen) ； 黃麗靜(Li-Ching Huang)

《馬偕護理雜誌》 13卷1期 (2019/01) Pp. 18-28

https://doi.org/10.29415/JMKN.201901_13(1).0002

摘要

本文為照顧一位腦中風年輕個案面對無望感之護理經驗，護理期間為2015年10月22日至11月21日，筆者運用Gordon十一項功能性健康評估工具，藉由觀察、會談、傾聽及直接照護等方式對個案進行生理、心理、社會及靈性等整體性評估，發現個案因肢體障礙，從一家之主的角色轉變成生活起居皆需仰賴他人協助，擔心未來須長期依賴他人，引發個案極大的衝擊及負向想法，對未來失去希望，因而出現身體活動功能障礙、無望感、潛在危險性肺吸入、知識缺失等健康問題。筆者提供以個案為中心的人性化照護，運用「人生照片」、「家庭支持系統」與「團隊力量」，使個案肯定自己存在的價值與建立希望感，增強其自信心，提升個案復健與學習自我照顧之動機；運用團隊力量及良好的家庭系統支持，協助個案正向面對疾病，順利重返家庭。

關鍵字

年輕腦中風 ； 身體活動功能障礙 ； 無望感 ； 潛在危險性肺吸入 ； 知識缺失

並列摘要

This case report described the process of nursing a young stroke patient experiencing the feeling of hopelessness. Nursing care was provided in the intensive care unit during the period of October 22 to November 21, 2015. Based on the Gordon's 11 functional health patterns, clinical observation, interviews and direct care were used to assess physical, psychological, social and spiritual aspects of health. The patient's role changes from independent to handicap. The patient and his family were worried about the patient's long-term dependency on others and leading toa great impact and negative attitude in the future. The patient's health problems were identified as the following: feeling of hopelessness, impaired physical mobility, risk for aspiration and deficiency in knowledge. The patient has improvedhis motivation in the activities of rehabilitation, carrying out self-care, enhancing self confidence and value after providing patient-centered care based on humanistic elements by using life photos, family support system and teamwork care. Under common care, the patient were able to cope with the disease with a positive attitude and successful discharge home and return to his ordinary life.

並列關鍵字

A youth with stroke ； feeing of hopelessness ； impaired physical mobility ； risk for aspiration and deficiency in knowledge