照護一位腔室症候群合併腓神經受損青少年之護理經驗

The Nursing Experience of an Adolescent Who Suffered from Left Leg Compartment Syndrome with Fibular Nerve Injury

一位17歲青少年，因車禍造成左小腿腔室症候群合併腓神經受損，導致行走功能障礙及身體外觀改變，本文探討照護此個案的護理經驗。筆者自2007年5月7日至8月2日照護期間，經由觀察、會談、傾聽、查閱病歷等方式收集資料，運用Gordon十一項功能性健康模式做整體性評估，加以歸納分析，確認個案主要有疼痛、組織完整性受損、焦慮、潛在危險性皮膚完整性受損、身體心像改變等五個護理健康問題。筆者以有趣的漫畫讀物－－灌籃高手、觀賞緯來體育台籃球賽及聆聽音樂配合深呼吸技巧等來分散注意力，減輕疼痛；提供適當傷口護理、教導傷口自我照護，以修復受損組織皮膚之完整性；藉由繪畫及自我鬆弛技巧等護理措施來舒緩個案情緒，減輕焦慮；提供足部護理來保護皮膚的完整性；運用社會資源談論澳洲無腿運動家－－約翰的故事，並提供勵志書籍－－五體不滿足，來激勵個案自信心，以持續性的關懷、鼓勵個案表達內心感受，運用同儕力量給予鼓勵與支持，來調適自己外觀上的改變，並克服個案心理上障礙，早日恢復自信心。

The aim of this case report was to report the nursing experiences of a 17 years old adolescent who suffered from body image changes and walking disability resulting form the complication of left leg compartment syndrome with peroneal nerve injure after a traffic accident. During the process of nursing care from May 7th, 2007 to August 2nd, the author collected information by observation, conversation, and listening to the patient and evaluated the patient by Gordon 11 health functional tools. Four health problems were identified, including pain, impaired tissue integrity, anxiety, risk for impaired skin integrity, and body image disturbance. First of all, the author encouraged the case to read interesting Japanese caricatures like Slam dunk and watch television sport programs for attention distraction to relieve pain. In addition, the author provided the patient with appropriate wound care and taught him self-care skill to prevent infection and repair tissue. The patient was taught to draw pictures and use selfrelaxing skills such as taking a deep breath and listening music to relieve anxiety. The author also provided the patient with a story of Joh Coutis and readings such as “No One’s Perfect” to encourage him. Through these real stories and consistent nursing care and supports from peers, the patient were finally able to find his personal identity and value and improve his self-confident and face the fact of appearance change.