照護一位腦中風病患吞嚥訓練之護理經驗

A Nursing Experience of Caring for a Stroke Patient with Difficulty Swallowing

本文為護理一位65歲男性患者，因腦中風後造成身心方面障礙之護理經驗。護理期間自2009年10月4日到2009年11月07日，筆者採用Gordon十一項功能性健康型態做為評估指引，確立個案主要護理問題有「吞嘸障礙」、「身體活動功能障礙」、「言辭溝通障礙」、「焦慮」等健康問題。護理過程提供個別性且整體性之護理措施，運用輔具協助吞嚥肌力訓練，並教導肢體活動訓練及構音技巧訓練，協助病患吞嚥及進食技巧，並以同理心的照護方式主動關懷並耐心傾聽病人的照護問題且積極提供醫療照護相關訊息及疾病衛教，減輕病人焦慮，進而協助個案以及主要照顧者能順利渡過疾病與復健治療過程。滿足個案的身、心理需求，恢復身體活動功能及吞嚥能力以達社交活動的目標，期望藉此護理經驗能提供護理人員臨床照護之參考。

This study describes a nursing experience of caring for a stroke patient with multiple dysfunctions. The nursing period was from October 4 to November 7, 2009. The author applied Gordon's 11 functional health patterns for nursing assessment. Through clinical observation and interviews, the following problems were identified: dysarthria, dysphagia, anxiety, and impaired mobility. The nursing process provides individualized and integral nursing interventions, including articulation skills training, oral muscles training for proper swallowing and feeding, and physical therapy for mobility. By means of active listening and empathic caring, the author provided patient education using care materials, minimized the patient's anxiety secondary to stroke, and assisted the patient and the caregiver in proceeding with physical rehabilitation. The ultimate goals for caring for the stroke patient with difficulty swallowing are to meet the patient's needs in physical and psychological aspects and recover functional mobility and swallowing. This article can be used as a reference for nurses caring for a stroke patient with difficulty swallowing in the future.