運用歐倫理論於青少年期脊髓損傷個案之復健護理經驗

隨著醫療與科技的進步，使脊髓損傷患者致死率降低，卻無法改變其失能情形。本篇描述一位14歲青少女由高處不慎跌落，造成第12胸椎至第2腰椎之不完全性脊髓損傷，衍伸下半身乏力、大小便失禁、情緒低落，而給予復健護理之過程。筆者自2009年12月3日至12月29日應用歐倫理論為評估架構，藉由觀察、會談、身體評估及病歷查閱等方式收集資料，發現個案所面臨之主要健康問題為身體活動功能障礙、自我照顧能力缺失（如廁）及無望感。經提供肌力訓練、膀胱訓練及排便訓練等復健計畫，並運用同理心瞭解個案需求，減輕對未來不確定感，終使個案能自行使用輔助器材上下床，增進生活自理能力，並得以重返校園生活。期望此護理經驗可提供臨床護理人員照顧類似個案的參考。

關鍵字

脊髓損傷；復健護理；青少年；歐倫理論；護理經驗

並列摘要

Medical and technological advances make it possible to reduce mortality in patients with spinal cord injuries, but have been unable to change it as a permanent disability. This paper describes the rehabilitation nursing experience of caring for a 14-year-old girl who accidentally fell. The patient's fall resulted in a spinal cord fracture, lower body weakness, incontinence, and depression. The first author was her primary nurse who took care of her between December 3 and December 29, 2009. Orem theory was used to evaluate the patient from observation, interviews, a physical assessment, and history gathering. The main health problems included impaired physical mobility, self-care deficiency, and feelings of hopelessness. The first author used empathy to understand the patient's needs, provided information to reduce the patient's uncertainty, taught the patient and her family to perform muscle power, bladder, and bowel training. By continuing rehabilitation program, the patient is able to get out of bed and return to campus life. This paper will provide a useful resource to our colleagues when caring for patients with similar conditions.

並列關鍵字

spinal cord injury ； rehabilitation nursing ； adolescent ； Orem theory ； nursing experience

國際替代計量

運用歐倫理論於青少年期脊髓損傷個案之復健護理經驗

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