一位第五頸椎損傷復建期病患之護理經驗

Nursing Experience of a Rehabilitated Patient with C5-Spine Injury

頸椎損傷多造成廣泛性的身體癱瘓，並導致心理、社會、發展等間題，造成個人、家庭生產及醫療社會資源之重大損失。本個案報告是描述照顧一位第五頸椎損傷術後於復健期之個案，於91年1月7曰至91年2月 14日期間以直接護理、會談方式及運用紐曼理論模式進行完整性護理評估。確立個案的主要護理問題有「慢性疼痛」、「自我照顧能力缺失」、「排尿型態改變」、「身體心像紊亂」、「無望感」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，進而協助個案與家屬共同擬定復健計劃，指導案夫及看護協助個案完成曰常生活照顧，並適時提供諮詢及轉介，幫助個案尋求安全感與心理支持，使個案漸漸願意面對未來的生活。由於此類個案需要長時間的調適，可轉介出院準備服務組及社工人員或支持團體持續提供出院後的生理及心理問題的協助。C-spine injury induces major palsy of the body, and gives rise to psychological, social and developmental problems. It damages person, family and social resources. This report describes the nursing experience of a patient during rehabilitation who suffered C5-spine injuries after an operation. Data were collected by caring, interviewing and analyzed using the Newman Systems Model from January, 7th, 2002 to February, 14th, 2002. The main problems of nursing are chronic pain, self-care deficit, altered urinary elimination, body image disturbance, hopelessness. Through building up and treating social relationships among the patient and her families, providing nursing intervention according these nursing problems, helping them to draft plans about rehabilitation, teaching the patient’s husband and attendant to help the patient complete self care, providing consultation for care problems at the right moment, and helping the patient to seek safe feeling and mental support, finally, little by little, the patient was able to face her future life. The results show the need of similar patients of a long period of time to adjust mentally. These results can be used in consulting nurses on preparing discharge and social workers or supporting organizations to continue to solve physical and psychological problems.