一位骨折截肢病患接受結腸造口復位手術之護理經驗

Nursing Experience of a Fracture Patient with Amputation Receiving Take down T Loop Colostomy

本文是探討一位骨折截肢病患接受結腸造口復位手術的護理經驗，筆者於2006年4月11日至2006年4月21日護理期間藉由實際護理個案、會談、及身體評估等方式進行資料收集，運用羅氏適應模式評估作為指引，發現個案有組織完整性受損、疼痛、身體活動功能障礙、及身體心像紊亂等護理健康問題，護理過程提供個案傷口護理，合宜的疼痛處理、藉由放鬆技巧減緩疼痛，加強肌肉力量及協助下床活動，並鼓勵正視身體的改變，使個案能從術後外觀改變及生活習慣改變的困擾，學習適應並積極配合治療，提高對自我的肯定，朝向有效性的整合，由於本文個案面臨骨折截肢再次住院手術接受結腸造口復位手術，所出現的護理問題及其調適過程，可以作為臨床照護骨折截肢病患及結腸造口復位手術病患的護理參考。

This case study reported the nursing experience for a fracture patient with amputation receiving take down T loop colostomy. The duration of nursing care was between April 11 and April 21, 2006. The Roy’s adaptation theory was used to assess nursing problem through direct care, systematic interview, and physical examination. Nursing problems identified included impaired tissue integrity, pain, impaired physical mobility, and disturbance body image. Nursing intervention programs included wound care, appropriate pain management, teaching relaxation for pain relief, enhancing muscle power, assisting performing getting of bed activities, and encouraging facing the reality of body change. The intervention enabled the patient learn to adapt her appearance and lifestyle change, cooperate with treatment, improve self-confidence, and achieve effective integration. The nursing experience can serve as a clinical reference for caring fracture amputation patients and take down T loop colostomy patients in the future.