照顧一位完全性胸髓損傷個案復健過程之護理經驗

本文是照顧一位完全性胸髓損傷之30歲男性，在復健過程之護理經驗。照護期間為2008年9月12日至2008年10月26日，筆者藉由觀察、會談與直接照護等方式蒐集資料，並運用Gordon十一項健康功能評估，發現個案此次住院期間，主要的護理問題為痙攣型神經性排尿障礙、身體活動功能障礙、慢性疼痛、性功能障礙及角色扮演改變。筆者安排具隱私性環境，並藉由示範及回覆示教等方式進行膀胱功能訓練，使個案可獨立執行導尿。督促個案運用漸進式復健方式，增強上肢肌力、坐姿平衡及維持下半身關節無攣縮。協助釐清神經性疼痛的原因及共同討論緩解方式，緩解疼痛並使個案接受與慢性疼痛共處之生活。評估個案性功能狀況，鼓勵參與本單位舉辦之性衛教團體活動及給予個別的性諮商，主動提供隱密環境讓個案夫妻進行性活動，使個案重拾性生活。介紹成功病友增加個案自信心，並協同治療師予職務再設計，協助轉介潛能發展中心進行生活自理訓練及職業訓練，讓個案適應受傷後的角色。

關鍵字

胸髓損傷；復健護理

並列摘要

This article describes a nursing experience caring for a 30-year-old male who was diagnosed with completed spinal cord injury. The primary nursing problems, including spastic neuropathic bladder dysfunction, physical disability, chronic pain, and sexual dysfunction, were found by the author through observations, interviews, and direct care. The Gordon Functional Health Measure was also applied as an assessment tool to collect information during the client's hospitalization. In order to help the client urinate independently, a private room was arranged so that he could receive demonstration of the technique and repeatedly practice bladder training exercises. The client was encouraged to restore the strength of his upper limbs, to balance sitting position, and to maintain the joints of his lower extremities from contracture using progressive rehabilitation. The client was taught the possible causes of neuropathic pain and was introduced to methods of relieving chronic pain. The author also evaluated the client’s sexual function, arranged a specific sexual counseling course, and provided a private environment to the client for intimacy. During the hospitalization, the author also helped the client meet other patients with the same diagnosis to exchange experiences to solve the client's concerns. The occupational therapist also re-designed the client's plan to meet his physical needs. The client was transferred to ”Potential Development Center” in order to promote his self-management of life and occupational training.

並列關鍵字

thoracic cord injury ； rehabilitation ； spinal cord injury

國際替代計量

照顧一位完全性胸髓損傷個案復健過程之護理經驗

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