運用羅氏適應模式照護一位顏面燒傷病患之護理經驗

Nursing Experience with a Facially Burnt Patient with Diabetes

王麗絹(Li-Chuan Wang) ； 鄭惠瑩(Hui-Ying Cheng)

《高雄護理雜誌》 27卷1期 (2010/05) Pp. 73-83

https://doi.org/10.6692/KJN-2010-27-1-7

摘要

本文運用羅氏適應模式，針對一位顏面燒傷病患進行護理評估，以觀察及會談等方式收集資料，確立個案有低效性呼吸型態、皮膚完整性受損、疼痛、身體心像紊亂等護理問題。護理期間，於急性期維持個案呼吸道通暢，傾聽、主動關懷並接納其心中感受，增加自主性與安全感，協助個案以正向的態度來適應此創傷，順利協助個案渡過急性期危機，並勇於面對燒傷後外觀之改變。期望藉由此護理經驗的分享，能提供護理人員對於燒傷病患照護之參考。

關鍵字

羅氏適應模式 ； 顏面燒傷 ； 護理經驗

並列摘要

This case report describes a nursing experience by using the Roy’s adaptation model and holistic nursing assessment in a patient with facial burns. Through collecting data by observation and interview, four nursing problems of this patient were established: ineffective airway clearance, impaired skin integrity, pain, and disturbed body image. In order to assist the patient adapt to this trauma with a positive attitude, the author strengthened her autonomy and safety through listening, providing persistent care, and accepting her feelings. The patient's airway was also maintained smoothly in the acute stage. Through this nursing experience, the patient was encouraged to face and accept the changes. It is expected that this case report can serve as a reference for the care of patients with burns.

並列關鍵字

Roy's adaptation model ； facial burns ； nursing experience