照顧一位中年男性急性腦中風合併失語症患者的護理經驗

腦中風一般較常發生在老年人，而本個案報告則描述照護一位48歲中年男性，因急性腦中風住進加護單位的經驗。照護期間為2010年10月17日至2010年11月08日。運用Gordon十一項健康功能評估作為資料收集指引，運用觀察、會談及書面資料，確立其護理問題包括腦組織灌流改變、身體活動功能障礙、言詞溝通障礙及身體心像紊亂。筆者在擬定護理計劃過程中，主動與個案討論計畫內容，也將個案家人納入照護計畫，個案的復健意願及自我價值可因家人的實質及情緒支持而增強。此外，讓個案及家人瞭解復健的目的及內容，可減輕其焦慮及不確定感。筆者因個案有語言溝通障礙問題，協助創造友好的溝通環境，以強化個案的溝通能力，藉此促進照護品質、個案自我認同及參與感，也可減低身體心像混亂對個案的衝擊。希冀本個案報告可提供照護此類個案的參考。

關鍵字

腦中風；身體活動功能障礙；失語症；身體心像紊亂

並列摘要

This case report depicted a 48-year-old man admitted to an intensive care unit due to an acute brain stroke. Care period was from 17 October to 08 November 2010. Gordon functional health patterns was used as guidance to collect patient data, including observation, interview, and documents. Nursing problems of case were a change of brain perfusion, motor function impairment, communication impairment, and body image disturbance. The willingness and self-value of the case was enhanced because family provided the case with practical and emotional support. Thus, the case and his family should be actively involved in nursing care activities. The case and his family should be informed the purpose and content of rehabilitation to ease their anxiety and uncertainty. Due to the communication impairment of the case, the nurse created a friendly communication environment to maximize his communication ability to improve care quality, selfidentity, and involvement, which also could decrease the impact of body image disturbance.