一位老年慢性骨髓炎患者之護理經驗

Nursing an Elderly Patient with Chronic Refractory Osteomyelitis

本篇係描述照顧一位因退化性關節炎行膝關節置換術導致慢性骨髓炎老年患者的護理經驗，護理期間為94年2月11日至3月11日。筆者運用觀察、會談以及整體性護理評估等方式收集資料，在照護過程中發現個案有高危險性傷害、疼痛、組織完整性受損、無望感等護理問題。除運用護理之獨立性功能、專業知識及技能以緩解個案生理上之不適外，亦藉由同理心，以傾聽、接納、關懷，鼓勵個案說出內心感受，強化家庭支持系統，使其情緒能得到適當的宣洩；另尋求相關醫療資訊，協助以正向態度接受治療，以共同討論方式訂定可行之護理活動，增強其對自我的控制感；提供醫師作適當之醫療選擇，進而使得醫、病關係能達到雙贏的結果。期望藉此護理經驗提供臨床護理人員照顧此類患者之參考。

This article describes the experience of nursing an elderly patient with chronic refractory osteomyelitis after total knee replacement for osteoarthritis. The duration of nursing care was between February 11th, 2005 and March 11(superscript th), 2005. The methods of data collection included observation, personal interviews and nursing evaluations. The patient's health problems included high risk of damage, pain, impairments of the whole organization, and hopelessness during the nursing process. In addition to using the independent functions of nursing, professional knowledge and skill to reduce the patient's physical discomfort, the researcher also used an empathetic approach to relieve the patient’s emotion by listening, receiving, caring, and encouraging the patient to express feelings, while reinforcing the family support system. In order to achieve a win-win interrelationship between physician and patient, the researcher searched the related medical literature to help the patient accept treatment with a positive attitude and to increase self-control. This case report aims to share the nursing experience and provide reference for clinical nursing specialists caring for similar cases.