本文是敘述一位62歲男性病患於接受椎板及椎間盤切除術併脊柱融合術期間的照護過程,筆者於個案住院期間(2009年8月25日-9月2日),藉由直接護理、觀察、會談、傾聽等方式收集相關資料,以Gorden十一項功能性健康型態進行評估,發現個案之健康問題為:1.焦慮/與其文化信念衝突,及擔心手術、麻醉後遺症有關;2.疼痛/與組織損傷及活動牽扯傷口有關;3.身體活動功能障礙/與脊椎手術後,傷口疼痛及不知道該如何活動有關;4.情緒性低自尊/因疾病導致生活型態改變有關的護理問題。筆者於手術前即介入照護,經由運用同理心瞭解其感受並提供正確資訊及信仰有關之資源、介紹成功案例協助建立信心以減輕術前焦慮,術後積極協助其緩解疼痛;以多次協助身體擺位、提醒及指正姿勢改善其活動方式的不確定感,降低身體活動功能障礙的影響,在恢復日常活動後進而提升自尊感受及自我價值感,期以此護理經驗能對類似個案提供更多的照護參考。
This article reported the experience of nursing a patient with lumbar disc herniation and stenosis undergoing lumbar surgery. The related information was collected by observation, conversation, and direct care from August 25 to September 2, 2009. Gorden´s 11 functional health patterns were used to evaluate the patient. The identified health problems included: anxiety, pain, impaired physical mobility, and situational low self-esteems. Before the surgery, the correct information, resources related to cultural belief, and patients with lumber surgery were provided to help the patient build up confidence and reduce anxiety. After the operation, pain management, assisting positioning and correcting posture were provided with the patient to reduce the uncertainty in activity and the negative impact of impaired morbidity. Patient´s self-esteem and values improved through increasing daily activities. This report provided the information about caring patient undergoing lumbar surgery with staff nurses.