使用Orem自我照顧理論照顧一位股骨頸骨折老人之護理經驗

A Nursing Experience Applying Orem's Self-Care Theory on an Elderly Patient with Femoral Neck Fracture

本文是探討一位81歲女性病人，因跌倒導致右股骨頸骨折，接受半人工髖關節置換手術後，協助其提升自我照顧能力之護理過程。護理期間為2010年2月5日至2月13日，筆者依據Orem自我照顧理論執行護理評估，確立其健康問題為急性疼痛、身體活動功能障礙、自我照顧能力缺失、潛在危險性感染及高危險性跌倒。協助病人疼痛控制、維持身體活動功能、改善肌肉強度、預防跌倒，並給予支持鼓勵，以增強自信心及自我照顧意願。提供出院後居家訪視及電訪追蹤居家照護情形，皆有助於病人提升自我照顧能力。筆者期望藉此次護理經驗，提供日後護理人員照顧此類病人之參考。This case report describes a nursing care experience in an 81-year- old patient who lost self care ability after hip hemiarthroplasty for right femoral neck fracture. The nursing period was from February 5th 2010 to February 13th 2010. Based on Orem's Self-Care Theory, we found that the patient suffered from five main health problems: 1.) acute pain, 2.) physical mobility impairment, 3.) self care deficit, 4.) potential risk of infection, and 5.) risk of falling down. According to these health problems, we provided physiological nursing care to the patient, such as controlling pain, keeping body mobility, improving muscle strength for walking and daily activities, preventing falling down, and encouraging and supporting for self-confidence and self care ability. In order to improve the patient's self care ability, we provided home-visiting, telephone interview and satisfied her needs of self-care. We would like to share this care experience as a reference for the nursing staffs who encounter similar difficulties in the future.