運用歐倫（Orem）理論照顧一位膝關節置換術病患之護理經驗

Nursing Experience of a Patient with Receiving Knee Replacement: An Application of Orem’s Theory

本文探討一位82歲女性，10年前因右膝骨關節炎進行全膝關節置換術，現亦因左膝相同疾病進行手術，面臨自我照顧困難之情境，護理期間自93年2月17日至3月3日，筆者以「歐倫(Orem)理論」評估病人自我照顧能力及缺失，確立個案有潛在危險性感染、身體活動功能障礙、知識缺失等護理問題。護理過程中有效運用完全代償、部分代償、支持及教育性護理系統，協助個案漸進性身體活動及膝關節復健，使其術後能自行運用助行器行動，改善活動功能障礙及自我照顧能力。此外建立個案正確安全用藥知識，以避免用藥不當之危害，並增進術後生活品質。希望藉此個案的護理經驗，提供骨科護理人員作為日後照顧此類病人的參考。

This paper reported the nursing experience of an eighty-two years old woman who has undergone left knee replacement because of osteoarthritis. Her right knee received the same surgery ten year ago. She was facing the difficulty of caring for herself. During February 17 to March 3 in 2004, the author applied the Orem Theory, confirming that the nursing problems of this woman included potential infection risk, the dysfunction of exercising, and the knowledge imperfection. During the nursing processes, the full compensatory, partial compensatory, and supportive and educational nursing systems were effectively applied to improve her physical function and self-care activity so that she could move freely using walking aids. Additionally, the patient was educated on taking medication correctly and avoiding drug misuse. Her life quality after the surgery was therefore improved. This nursing experience was expected to be an example for orthopaedic nursing staff taking care of similar cases.