本文分享一位腦性麻痺病童有呼吸道感染及營養攝取不足問題,案父母對於個案生理照護能力不足,且對出院返家照護意願低,而使個案無法順利出院。筆者自2018年1月3日至2月1日運用觀察、溝通、身體評估等方式收集資料,整體性評估確立有呼吸道清除功能失效、營養不均衡:少於身體所需、親職功能障礙及家庭因應失能等健康問題,以個別性指導案父母的照護技能,納入團隊成員實際參與照護,以一對一指導及回覆示教方式,協助案父母於個案出院前成功執行鼻胃管灌食及胸腔照護技巧,並以家庭為中心照護模式,促進個案與父母依附關係,提升照護意願,成功協助家庭因應。透過整合醫療、家庭及政府資源,解決個案及其家庭問題,達到全人及持續性照護。
This study discussed a case in which a child with cerebral palsy developed respiratory tract infection and malnutrition. The parents exhibited insufficient capacity in providing physical care for the child and low willingness to discharge the child from the hospital to care for him/her themselves, hindering the child from hospital discharge. This study collected data by observing, communicating with, and conducting physical assessment about the child in a period between January 3 and February 1, 2018. The integrated assessment confirmed that the child had developed ineffective airway clearance, imbalanced nutrition, malnutrition, and other health problems including impaired parenting and disabled family coping. This study provided individual training on care skills to the parents. The parents were included in the care team and participated in actual care. One-on-one coaching was provided to the parents, who were then asked to repeat the demonstrations. This training was aimed at enabling the parents to perform nasogastric tube feeding and chest care before the child was discharged from the hospital. The family-centered care model was implemented to boost the attachment relationship between the child and parents, enhance the parents' willingness to care for the child, and improve family coping. This study solved the problems the child and their family faced by integrating medical, family and government resources, thereby achieving holistic and continuing care.
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