照顧脊柱側彎之學齡兒童接受脊椎手術的護理經驗

The Nursing Experience of a School-aged Child with Scoliosis Receiving the Spinal Surgery

本文係描述一位因脊柱側彎，接受胸腰椎手術之學齡期兒童的護理經驗。筆者於2007年6月29日至7月9日，藉由觀察、與個案及父母會談、病歷查閱等進行資料收集，運用Gordon十一項功能性健康型態進行評估，歸納有四項主要護理問題，包括焦慮、疼痛、自我照顧能力缺失及身體心像改變等。針對個案問題除協助緩解手術所引起之焦慮及降低手術後傷口疼痛外，藉由護理人員及家屬之關心與支援，與個案共同討論可以達成之照護目標，提升個案自我照顧的動機，並接受外觀身體心像的改變，使個案早期下床，早日適應返家後的日常生活活動。期望此護理經驗，提供往後照護此類個案之參考。

This article reported the nursing care giving to a ten year-old child affected by scoliosis who had undergone thoracolumbar operation. Information regarding the patient condition was collected by chart review, interview, observation, and physical assessment between June 29th and July 9th, 2007. Direct nursing, parent interview, and Gordon’s 11 functional health patterns were applied for diagnostic purpose. Four nursing problems, including anxiety, pain, self-care deficiency, and body image change were observed. The nursing implements involved reducing pre-operation anxiety and alleviating postoperation pain of wound, motivating patient’s intention for self-care through nursing staff’s and family’s care and support, accepting the perception of body image change, and overcoming the impact of the disease. During the nursing process, proper general as well as individualized guidance is required to achieve the unique function of nursing.