一位老年男性行左膝全人工膝關節置換術之照護經驗

The Nursing Experience of Caring an Elderly Male who Receives Left Total Knee Replacement

本篇報告是探討一位患有退化性膝關節炎之老年男性，接受左膝全人工關節置換手術之照護經驗。照護期間為2007年10月28日至2007年11月03日，筆者藉由直接護理、觀察及會談收集資料，並利用Gordon十一項功能性健康型態評估來確認其護理問題，結果發現個案有焦慮、疼痛及身體活動功能障礙等主要護理問題。面對老年個案，筆者運用同理心給予詳細的術前衛教，並且於術後介紹成功病友，來減輕個案的焦慮；依據實證護理執行有系統的護理措施，成功降低個案術後的疼痛不適；與個案共同制定下床計畫及教導個案運用漸進式的復健運動，促使個案能如期出院。期望透過此個案護理經驗，能提供護理人員往後照護這類病患之參考。The aim of the paper was to describe the experience of nursing care for a male elderly patient with total knee replacement of his left knee due to osteoarthritis. Data were collected through direct nursing care, observation and interviews. During patient's hospitalization between Oct 28th and Nov 3rd, 2007, the author applied Gorden's 11 functional health status assessment criteria for evaluating a patient and establishing nursing diagnosis. The patient's nursing problems were anxiety, pain and impaired physical mobility. To release this elderly patient's anxiety, the author provided detailed coach with empathy to him before surgery and introduced wardmates with successful recovery experiences from the same surgery after his operation. The author also implemented an evidence-based systematic nursing process to relieve the patient's pain during post-operation care. With the patient's participation and agreement, the author established a step-by-step physical exercise plan to gradually rebuild his mobility to meet the expected discharge date. The author anticipates that this case study can assist other nurses in their practice of caring for patients with similar health care needs.