Orem自我照顧理論運用於一位老年迴腸造口病患之護理

Applying Orem's Self Care Theory to an Old Patient with Ileostomy

黃靖(Ching Huang) ； 徐惠禎(Hui-Chen Hsu)

《東港安泰醫護雜誌》 11卷2期 (2005/06) Pp. 103-113

https://doi.org/10.7078/TSMHMNJ.200506.0103

摘要

本文敘述一位老年獨居又需獨立照顧自己的結腸癌病患，手術後因身體結構功能改變、造口存留產生異味及失去正常排泄功能，出現身體、心理、社會各層面很大的衝擊，影響自我照顧能力，筆者依據Orem理論之概念-自我照顧能力不足、護理系統等評估患者，確定個案之主要護理問題有：一、睡眠型態紊亂；二、身體心像紊亂；三、家庭運作過程改變；四、情境性低自尊。為使個案能增強自我照顧能力，應用歐倫理論的護理系統－完全代償性、部份代償性及支持教育性，在短時間即與個案建立良好護病關係，指導並陪伴患者與家屬執行各項治療及護理活動，使個案在接受治療後，增加個人的信心，並於日後生活提升自我照顧的能力，早日回歸社會中。

關鍵字

歐倫自我照顧理論 ； 迴腸造口 ； 家庭運作過程改變

並列摘要

This article describes an old, solitary man with colon cancer who needed to take care of himself. After operation, his ability of self-care was affected; besides, he started to have lots of impacts in physical, mental and social levels because of alternation of body structures, bad odor resulting from colostomy and loss of normal ability in defecation.
The author evaluated this patient according to concepts of Orem's theory-inadequate ability of self-care and nursing system and came out with the following major nursing problems: I. Sleep pattern disturbance, II. Body image disorder, III. Family processes altered, IV. Self-esteem, situation Low. In order to enhance this case the ability of self-care, the author applied Orem's nursing system-completely compensatory, partially compensatory and educationally supportive concepts to build up a good relationship between patient and nursing staffs, provide patient and his family various instructions and accompanies while performing every treatment and nursing activity, increase personal confidence after receiving therapy, improve the ability of self-care in the future and be able to return to society as early as possible.

並列關鍵字

Orem's self care theory ； Ileostomy ； Family processes altered