協助一位921震災截肢患者創傷後反應及身體心像重建之護理經驗

Nursing Experiences ofthe Post-Trauma Response and Body Image Reconstruction of an Amputated Woman due to 921 Earthquake

臺灣921大地震，造成全臺重大的傷亡。對在震災中受傷的個人而言，身體外觀、結構或功能的改變都是個極大的壓力。若不及時處理，將造成其身心無比的傷害。本文探討一位婦人在震災中雙腳受重物壓傷，行左膝上截肢後，對身體心像之改變，出現沈默、哭泣、退縮及自責等行為反應。筆者於護理過程中，運用主動關懷、同理及接受等支持方式，藉由直接護理，取得個案信任，並建立良好護病關係。此外，在家屬的支持與配合下，共同協助個案接受已截肢的事實，學習照顧患肢，並重建正向之自我概念。此護理經驗能提供同仁重現截肢病人的問題，並提供同仁日後照顧之參考。The 921 earthquake caused serious damage around Taiwan. Those who were injuried during the whole event, experienced great stress due to changes in their body appearance, structure or/and function. A 37-year-old woman showed silence, crying, withdrawal, and self-blaming behaviors when she faced left leg above knee amputation due to be crushed in the earthquake. Based on concepts of caring, empathy, and acceptance, a positive nurse-patient relationship was established through direct nursing care. Nevertheless, support from family helps patient accepts the reality of amputation, learn to perform self-care, and re-build positive self-concept. This experience can help nurses to take care of the amputated patient.