協助一位腦中風個案出院準備服務的經驗

A Nursing Experience of Discharge Planning Service for a Cerebrovascular Accident Patient

陳儀倩(Yi-Chien Chen) ； 陳妤靜(Yu-Jing Chen) ； 呂孟倫(Meng-Lun Lu)

《高雄護理雜誌》 35卷1期 (2018/04) Pp. 150-160

https://doi.org/10.6692/KJN.201804_35(1).0013

摘要

本文描述個案二次中風致左側肢體偏癱及鼻胃管留置，且唯一的獨子於4月車禍身亡，在雙重打擊下產生無望感危機。護理期間自2013年5月14日至6月13日，運用Gordon 11項功能性健康型態為評估工具，護理問題為身體活動功能障礙、吞嚥困難、無望感及照顧者角色緊張。運用出院準備服務之概念，在跨專業團隊合作下共同擬訂照護計畫，除了提供適宜的飲食衛教與激發個案積極復健的動力，更因吞嚥訓練進而減少嗆咳，成功移除鼻胃管。照護過程佐以各項社會資源協助，亦提昇主要照顧者信心，減少其身心負荷，維持家庭功能正常運作，希冀藉此個案的照護經驗，提供出院準備服務團隊在未來照護相似案例之參考。

關鍵字

出院準備服務 ； 腦中風 ； 無望感 ； 吞嚥困難

並列摘要

This is an article on a patient who had left hemiplegia requiring an Indwelling NG Tube as a result of a second-time stroke. Moreover, due to the fact that his only son passed away in a car accident in April, this double misfortune contributed to the patient's sense of hopelessness. The nursing period was between 14th May to 13th June 2013, and an evaluation method known as Gordon's 11 Functional Health Patterns was utilized. The case involved several nursing issues such as impeded body motor functions, dysphagia and hopelessness, as well as the caretaker's feelings of nervousness. Utilizing the concept of Discharge Planning as well as the combined efforts of the multi-disciplinary team, a nursing plan was formulated, which provided appropriate dietary education, encouraged the patient to verbally express his inside feelings and have rehabilitation as soon as possible, and helped in contributing to the patient's fast recovery and removal of the Indwelling NG Tube through swallowing training. The nursing procedure was comprised of utilizing various types of community resources, raising the caretaker's level of confidence, minimizing the patient's physical and emotional burdens, and maintaining healthy family function. It is hoped that this case study can act as a future reference for Discharge Planning Teams in view of similar cases.

並列關鍵字

discharge planning service ； cerebrovascular accident ； hopelessness ； dysphagia

參考文獻

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