照護一位多發性腦膿瘍中年婦女之復健護理經驗

Rehabilitation-Nursing Experience about Taking Care of a Middle-Aged Women with Multiple Brain Abscess

中樞神經系統是生命與意識的主宰，一旦發生感染必然非常嚴重，甚至會危及性命。本篇報告主要描述照護一位罹患多發性腦膿瘍之中年婦女的復健護理經驗。個案因腦膿瘍導致無法執行自我照護且出現外觀及角色功能改變等問題，護理期間自2008年3月28日至5月5日，筆者運用羅氏適應模式進行評估，以觀察、會談、身體評估及病歷查閱等技巧進行資料收集，發現個案有身體活動功能障礙、身體心像紊亂和角色扮演改變等健康問題。筆者經由跨團隊的整合，設計符合個案需求的肢體復健運動計劃使其增加肌肉力量，進而能自行使用助行器下床活動並執行基本的自我照護活動。運用符合個案需求的裝扮方式讓其對自己外表的信心增加，進而接受外觀改變的事實。透過與家庭成員共同討論對策，協助個案調整其角色功能的扮演，適應疾病過程並積極復健，進而順利出院。期望此篇文章可提供日後護理人員在照護類似個案之參考，使個案及家屬能獲得適切的護理照護。

Central nervous system (CNS) is the master of human life and consciousness. CNS infection is a serious condition and sometimes can be fatal. This article described the rehabilitation-nursing experience of taking care of a middle-aged women with multiple brain abscesses. During the period from March 28th to May 5th in 2008, we used Roy’s model to evaluate the patient by observation, interview, physical assessment, and history taking. We found the problems of this patient included physical instability, psychological disorientation, intolerance to appearance change, and confusion of self-identity. We used physical rehabilitation to intensity her muscle power; used role play to help her increase the confidence and then accept the truth of her outside looking change. We also discussed with her family about how to take care of this patient to improve her self-identity and let her adapt to the nature disease process and then be discharged as soon as possible. We hope this article can serve as a reference for nurses taking care of similar patients and communicating with family members.