從醫院到社區－運用彈力帶運動訓練於一位反覆跌倒高齡病人的護理經驗

From Hospital to Community: A Nursing Experience Report on Using Elastic Band Exercises to Train an Older Patient Who Had Repeated Falls

廖羿婷(Yi-Ting Liao) ； 簡翠薇(Tsui-Wei Chien)

《榮總護理》 38卷2期 (2021/06) Pp. 150-157

https://doi.org/10.6142/VGHN.202106_38(2).0005

摘要

本文旨在描述一位反覆跌倒的高齡病人，從住院至出院返家的護理經驗。護理期間為2020年2月27日至6月11日，病人於家中跌倒後因意識喪失至急診就醫，隔日轉入病房照護。住院期間筆者以周全性老年評估為架構，並透過觀察、會談、身體評估及病歷查閱，確立病人主要的健康問題為潛在危險性損傷：跌倒、便秘與無力感。病人於3月7日出院後，筆者仍持續每週進行居家訪視，共12次。住院期間除復健治療外，並加入彈力帶進行八週的阻力運動訓練，每週四次，每次40分鐘，增加肌肉力量及平衡功能，並協助轉介長期照顧十年計畫2.0，改善居家環境，護理期間未再發生跌倒情形；透過增加高纖維飲食、液體攝取及活動量，改善其便秘問題；運用傾聽、關懷、同理心等技巧鼓勵病人表達情緒感受，病人也因獨立性增加，進而改善其無力感。希望藉此護理經驗的分享，作為日後醫護人員照護高齡病人之參考。

關鍵字

周全性老年評估 ； 彈力帶 ； 反覆跌倒 ； 高齡病人

並列摘要

This article describes the nursing experience of an older female patient, from hospitalization to discharge, who had fallen repeatedly. The nursing period was from February 27 to June 11, 2020. The patient was transferred to emergency room care due to loss of consciousness after a fall at home, and she was transferred to the ward on the following day. During the patient's hospitalization, the author used a comprehensive geriatric assessment as a framework for administering care. Through observation, interviews, physical assessment, and medical record review, the following conditions of the patient were identified as primary risk factors for injuries: falls, constipation, and a feeling of powerlessness. After the patient was discharged from the hospital on March 7, the author conducted weekly home visits 12 times a week. In addition to rehabilitation treatment during the hospitalization period, an elastic band resistance exercise was prescribed for 8 weeks, which was to be conducted four times a week and for 40 min each time; the purpose of this exercise was to increase muscle strength and balance. Furthermore, guidance provided by the 10-Year Long-Term Care Project 2.0 was used to improve the patient's living environment. No falls occurred during the nursing period. The patient's constipation was improved by increasing the patient's fiber intake, fluid intake, and activity level. The author used listening, caring, and empathy strategies to encourage the patient to express her emotions and feelings, and the patient also improved her sense of independence and reduced her feelings of powerlessness. We hope that this report on this nursing experience will help medical staff better care for older patients.

並列關鍵字

comprehensive geriatric assessment ； elastic band ； repeated falls ； older patients

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