照顧一位因車禍導致下半身癱瘓個案之護理經驗

Nursing Experience from Caring for a Paraplegic Patient Resulting from a Traffic Accident

劉季旻(Ji-Min Liu) ； 廖玉美(Yu-Mei Liao)

《高雄護理雜誌》 36卷1期 (2019/04) Pp. 91-103

https://doi.org/10.6692/KJN.201904_36(1).0009

摘要

本文描述一位因突發性車禍，致頸部第二至五節脊髓損傷而下半身癱瘓之個案照護過程，照護期間自2015年12月19日至2016年1月22日，運用生理、心理、社會、靈性層面進行整體性護理評估，並藉由身體評估、會談等方式收集資料，確立個案有呼吸道清除功能失效、身體活動功能障礙及無望感等健康問題。照護過程中，透過護病信任關係建立，主動關懷、鼓勵、傾聽個案需求，引導正向想法並勇敢面對未來，提供芳香、音樂等方法及跨領域團隊介入來滿足個案健康照護需求，以正確的疾病照顧資訊與技巧，改善生理問題，降低感染機會、增加身體肌力，提昇個案自我照顧能力，並重拾信心面對疾病渡過無望感過程。期望藉此分享，未來照護此類個案時更能掌握其健康需求，進而提升護理照護。

關鍵字

脊髓損傷 ； 無望感 ； 呼吸道清除功能失效

並列摘要

This article describes a case of paraplegia due to a sudden traffic accident resulting in spinal cord injuries from C2-C5 levels, during the period from December 19, 2015 to January 22, 2016. A holistic nursing assessment was conducted through physical, psychological, social and spiritual methods and data collection was done through health evaluation, interview…etc. in order to confirm the case had ineffective airway clearance, physical activity dysfunction, and feelings of hopelessness. In between the process of nursing case, through the establishment of the relationship of care and trust between nurses and patient, we gave individual support, listened to his feelings, cared for and guided the patient to positive thinking to face the future bravely. We provided aroma and music therapy as well as the interdisciplinary team involved in meeting the needs of the patient's health care. We used correct information and skills of diseases care to improve physical problems, reduce chances of infection, increase body strength, enhance the patient’s ability to take care of himself and regain confidence in the process of hopelessness from the disease, and bravely face the impact of the disease in daily life. We hope the relevant nursing staff could understand patient health needs in caring for such cases in the future so that such care and attention can be enhanced through sharing our nursing case experience.

並列關鍵字

spinal cord injury ； hopelessness ； ineffective airway clearance

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