照顧一位行全膝關節置換術個案之護理經驗

Nursing Experience of a Patient Receiving Total Knee Replacement

本篇為探討一位左膝因退化性關節炎進行全膝關節置換術的個案，護理期間自2007年7月25日至7月31日，運用觀察及會談技巧收集資料，以Gordon十一項功能性健康型態進行整體性評估，確立個案主要健康問題有焦慮、疼痛、身體活動功能障礙等護理問題。護理過程中筆者藉由良好的護病關係的建立，針對個案需求提供個別性的護理措施，協助面對心理及生理的健康問題，降低術前焦慮及緩解術後疼痛並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，進而提升生活品質。期望此護理經驗對日後照顧此類個案之臨床護理同仁能有所助益。

The purpose of this article was to describe the nursing experience of a patient who has undergone left knee replacement because of osteoarthritis. During the caring period from July 25 to July 31, 2007, the author applied the Gordon’s 11 functional health assessment tool and identified problems of anxiety, pain, and dysfunction of exercising. With the establishment of good nurse-patient relationship, individualized nursing intervention according to the patient needs was proposed to intensively deal with the physical and psychological discomfort of the patient. It helped to reduce the preoperative anxiety and postoperative pain, and to improve self-care activity so that patient could move freely using walking aids. Quality of life after the surgery was therefore improved. This nursing experience provided our fellow nurses with a practical reference in their clinical practices.