自發性腦出血病人及其主要照顧者之護理經驗

Nursing Experience with a Spontaneous Intracerebral Hemorrhage Patient and Caregiver

林如錚(Ju-Cheng Lin) ； 黃素珍(Su-Chen Huang)

《北市醫學雜誌》 5卷1期 (2008/02) Pp. 128-136

https://doi.org/10.6200/TCMJ.2008.5.1.14

摘要

本文旨在描述一位自發性腦內出血病人的護理經驗，護理期間為95年9月25日至10月12日，以Gordon 11項健康功能型態為評估架構，採觀察、傾聽、會談及溝通方式蒐集資料，結果個案有：現存性危險性感染、便秘、身體活動功能障礙及照顧者角色緊張等健康問題。經由噴霧治療、背部叩擊、定時翻身、增加活動量及增加水分攝取；給予大便訓練；透過被動性及主動性全關節運動之執行；主動關懷案妻並示教及回示教照顧個案的相關技能等護理措施介入後，結果使個案免於呼吸道及泌尿道感染的傷害，排便功能也恢復正常；患側肢體關節無攣縮變形現象，且讓案妻熟悉照顧個案的相關技能後，減輕緊張及焦慮並有信心參與照護。

關鍵字

自發性腦內出血 ； 身體活動功能障礙 ； 照顧者角色緊張

並列摘要

Background and Purpose: The purpose of this study was to describe nursing experience while caring for a patient who had suffered a spontaneous intracerebral hemorrhage; this involved helping him deal with his health problems and obtaining social support for the caregiver after the event. Methods: Gordon's eleven types of health functions were used as the conceptual framework. Data were collected by observation, interview and communication, etc. Results: The results revealed that this patient had the following nursing problems: (1) risk of infection (respiratory and urinary tracts) (2) constipation (3) impaired physical activity (4) the presence of caregiver role strain. Conclusion: By adopting relevant nursing interventions and nursing care (including steam inhalation, back percussion, regular repositioning, increased physical activity, adequate hydration, defecation training, a passive and active range of motion exercises and active participation by and care training of the caregiver), we were able to effectively reduce the risk of infection, restore defecation function, avoid limb contracture of paralytic site and encourage the caregiver so that their stress and anxiety were reduced. Finally, we were able to build up the confidence of the caregiver and provide the skills necessary for patient support.

並列關鍵字

spontaneous intracerebral hemorrhage ； mobility ； impaired physical ； caregiver role strain