一位顱內出血息者行開顱手術後復健期之護理經驗

Rehabilitation of Intracranial Hemorrhage Patient Following Craniotomy

何巧琳(Ciao-Lin He) ； 李梅琛(Mei-Chen Lee) ； 簡翠薇(Tsui-Wei Chien)

《醫護科技學刊》 8卷3期 (2006/07) Pp. 237-248

https://doi.org/10.6563/TJHS.2006.8(3).7

摘要

本文主旨為描述一位因頭部外傷導致顱內出血患者行開顱手術後復健期之護理經驗，照護過程中（93/12/06至93/l2/29）運用羅氏適應模式進行收集生理、心理、社會之適應行為相關資料，並歸納出個案有身體活動功能障礙、言辭溝通障礙、無望感、潛在危險性廢用症候群等護理問題。於護理過程藉由肢體活動訓練計劃提昇個案活動程度、採個別性之語言訓練增進個案與他人之溝通能力，針對活動受限而泛生之潛在危險性廢用症候群，則採取必要性的預防措施，避免因不活動而產生許多器官的合併症。此外，個案因遭逢意外喪失肢體活動及言辭溝通功能而導致無望感，護理措施則利用與家屬、病患建立良好的治療性人際關係，強化個案目前現有的生理功能，及應用其熟悉的同儕、師生關係給予加強關懷及心理支持，並且運用宗教信仰增進其靈性的安適，而逐步引導患者持續維持希望的結果。

關鍵字

顱內出血 ； 開顱手術 ； 復健期

並列摘要

Post-craniotomy rehabilitative nursing care provided to a head injury patient with traumatic intracranial hemorrhage is described. The patient received nursing care from December 6-29, 2004. Roy's adaptation model was used to analyze relevant data regarding the patient's adaptive behavior of physiology, mentality, and society. The following problems were identified: impaired physical mobility, impaired verbal communication, hopelessness and risk for disuse syndrome. A limb activity plan was implemented to promote limb function, and a verbal retraining program was employed to increase communication capability between the patient and the others. Because the restriction of body activity function, we adopted the precautionary measure to avoid risk for disuse syndrome. The patient also presented symptoms of hopelessness after losing verbal communication capability and physical mobility. The nursing measures for treating hopelessness were to build up a good interpersonal relationships between the patient and families and relatives, strengthen existing physical function, to provide concern and mentality support from visiting colleagues and students, and to strengthen spirituality close to quiet and comfort by using religious belief. Gradually leading the patient to continue to maintain hope, the process of rebuilding hope was difficult and arduous, but we finally found the positive adaptive behavior on the patient's body.

並列關鍵字

Intracranial hemorrhage ； craniotomy ； stage of rehabilitation

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