一位腦中風病患及其主要照顧者之護理經驗

The Nursing Experience of a Patient with Stroke and his Primary Caregiver

本文旨在描述一位腦中風病患及其主要照顧者之護理經驗。加護病房護理期間自2008年6月18日至7月10日，轉普通病房後8次探訪及出院後5次電訪，以Gordon 11項功能性健康型態為評估架構，採身體評估、觀察、訪談等技巧收集主、客觀資料，確立個案的護理問題包括：呼吸道清除功能失效、潛在危險性廢用症侯群、照顧者角色緊張。筆者藉由護理過程，協助病人噴霧治療、胸部物理治療、增加活動量及水分攝取，透過執行被動全關節運動，主動關懷主要照顧者及回覆示教照顧個案相關技能等護理措施介入後，結果使個案維持呼吸道通暢及免於泌尿道感染的傷害、患側關節無攣縮、腸胃道維持通暢及皮膚維持完整性，且提供主要照顧者運用社會資源和熟悉照顧個案相關技能，進而維持病患良好的照顧品質。

The aim of this article was to describe the nursing care experience of a patient with stroke and his primary caregiver. The nursing care period was from June 18 to July 10, 2008 at an intensive care unit, and 8 visits after the patient was transferred to the ward, and 5 telephone interviews after discharge. Gordon’s 11 functional health patterns were used as an assessment framework. Data were collected from various aspects including physical exam, observation, and interviews. The nursing problems confirmed included: ineffective method of clearing airway, risk for disuse syndrome, and caregiver role strain. Through nursing process, the author helped the patient with taking the inhalation and chest physical therapy, increasing physical activity and water intake, taking a passive range of motion, caring for his primary caregiver, and reinforcing the skills on how to take care of the patient. As a result, these interventions helped the patient breath smoothly, avoided the damage of urinary tract infection and joint contractures, kept gastric-intestine tract function normally, and maintained skin integrity. In addition, the primary caregiver had been familiarized with nursing care skills. In order to reduce the caregiver’s stress, the social resources were also provided. Finally, these interventions provided good quality of care for the patient.