學齡期兒童接受殘肢重建之護理經驗

Nursing Care of a School-aged Child Who Underwent Stump Revision

本文探討一位學齡兒童左下肢殘肢接受重建之照護經驗。筆者於2007年9月13日至9月24日照護期間，經由直接護理、觀察、會談、傾聽與病歷查閱等方式收集資料，運用Gordon十一項功能性健康型態進行評估，加以歸納分析，確認個案有焦慮、疼痛、身體心像紊亂、照顧者角色緊張等護理問題。筆者提供繪畫、治療性遊戲來緩解個案的焦慮；以有趣櫻桃小丸子卡通故事影片及聆聽卡通音樂－－珍珠美人魚來轉移對疼痛之注意力；引導個案說出內心感受，介紹勵志故事－－獨腳提琴手，讚賞個案的優點來肯定自我能力與才華，協助個案早日接受身體並維持正向身體心像；鼓勵案母說出內心的感受、指導照顧技巧並回覆示教、尋求社會資源，以降低照顧者緊張。

This article describes the nursing experience of a school-aged child who underwent left lower limb stump revision. The nursing period was from September 13th to September 24, 2007. The author assessed the patient’s health condition by direct nursing, observation, interview, listening, and chart review using Gordon’s 11 functional pattern assessments. The patient had four nursing problems: anxiety, pain, and body image disturbance and role tension of caregiver. The author provided nursing measures like drawing, therapy playing to alleviate anxiety; and interesting stories cartoon about Chibi Maruko and listening to music-pearl mermaid, to divert attention from pain; encourage the patient to express her feelings, and introduced that pursues a goal with determination the story-alone foot fiddler, and appreciates the merits of the patient of self-recognition abilities and talents to help the case as soon as possible maintain a positive body image. We also encouraged the mother of the patient to talk about her inner feelings, to guide care reply teaching skills, and to seek community resources to reducem caregiver stress.