運用Orem理論於一位熱中暑患者的護理經驗

Applying Orem’s Theory to Nursing a Heatstroke Patient

熱中暑是一個死亡率很高的內科急症，在溫室效應下，有日益增多的趨勢，若能早期辨識及積極降溫，可降低死亡率及減少殘留神經障礙。本文運用歐倫自我照顧理論，針對一位熱中暑倖存者，但仍存有神經學缺損病患進行全面性護理評估，護理期間為94年8月10日至8月31日。發現個案有「自我照顧能力缺損」（穿衣、進食、如廁、沐浴）、「潛在危險性跌倒」、「言詞溝通障礙」、「焦慮」、「身體活動功能障礙」等問題，護理人員經由與個案及家屬建立關係，協助指導並陪伴執行各項治療與復健活動，增加個人對復健的信心，提升自我照顧能力，預防意外事故，增進非語言及語言的溝通能力，運用家庭支持系統以緩解個案的焦慮，達到最佳的調適及維持生活品質。

Heatstroke is an acute medical syndrome with a high mortality rate. The incidence of heatstroke is increasing due to the greenhouse effect. Mortality and residual neural disorders due to heatstroke can be reduced by early diagnosis and actively lowering the patient's temperature. This article describes the experience of nursing a patient who survived heatstroke using Orem's theory with total nursing evaluations. Care was provided from August 10(superscript th) to 31(superscript th), 2005. The patient's health problems included impaired physical mobility, impaired self-care ability (such as dressing, eating, using the toilet, and showering), potential falling risk, barriers to verbal communication, and anxiety. For these problems, the author designed a nursing plan that included establishing the interrelationship between the patient and his family, teaching and accompanying the patient while doing therapy and rehabilitation activities, increasing the patient's confidence and self-care abilities, preventing accidents, as well as increasing non-verbal and verbal communication ability. In addition, efforts were made to reduce the patient's anxiety by strengthening the family support system to achieve the optimal accommodation and to maintain good quality of life.