運用Orem理論於一位疑似鉤端螺旋體病患者之護理經驗

Applying Orem’s Theory to Care of a Patient with Suspected Leptospirosis

本篇報告是藉由照顧一位疑似鉤端螺旋體病個案，運用歐倫自我照顧缺失理論為臨床護理評估架構，以參與及會談方法收集資料，進行護理評估。發現個案主要護理問題為「呼吸道清除功能失效」、「組織灌流改變」、「體溫過高」、「自我照顧能力缺失」及「知識缺失」等五項；筆者經由與個案及家屬建立關係，針對護理問題給予護理活動，而護理活動提供完全代償性護理、部份代償性護理及支持教育性護理；結果評值護理目標已部份達成，並進行後續追縱，顯示經由此理論完整的評估及護理措施的介入，使得個案不適症狀能獲得緩解，並提升個案及家屬對疾病的認知與照顧能力，進而改善其生活品質，希望藉此經驗分享,提供護理人員在照顧此類個案之參考。

The purpose of this study was to provide care during the adjustment process of a suspected case of leptospirosis through clinical nursing appraisal using Orem's self care deficit theory, participation and discussion of collected data. Five main nursing problems were noted: 'ineffective airway clearance', 'tissue perfusion failure'. 'hyperthermia', 'self care deficit' and 'lack of knowledge'. We established a relationship with the patient and family for the purpose of determining nursing care problem and activities, providing wholly compensatory nursing, partly compensatory nursing and supportive-educational nursing. Results showed that our nursing were partially achieved. Using Orem's theory for appraising the situation and determining nursing involvement measures facilitated handling of this case by fostering a more holistic understanding of the disease among the professional caregivers. Applying the theory also improved the ability of the patient's relatives to provide care by increasing their knowledge about the disease, consequently improving their quality of life. This case report provides referential experience for nursing personnel.