照顧一位因藥物濫用併發脊椎骨髓炎個案之護理經驗

A Nursing Experience for a Patient with Spinal Osteomyelitis Secondary to Drug Abuse

本文探討一位因棄物濫用而併發脊椎骨髓炎導致身體病痛及心理焦慮個案的護理經驗。護理期間自2010年3月1日至4月15日，藉由觀察、會談及身體評估方式進行資料收集，並運用羅氏適應理論進行整體性評估，歸納個案有急性疼痛、現存性感染和面對脊椎手術預後及藥物濫用治療造成的焦慮等護理問題。脊椎骨髓炎的治療至少需四週，在這漫長的住院中，筆者以傾聽、主動關懷的態度與個案建立良好的護病關係，並運用護理技巧減輕個案對脊椎手術預後和治療藥物濫用的焦慮問題，配合非獨立和獨立性的護理來解決個案的急性疼痛；且針對現存性的感染問題給予適當的抗生素治療和預防感染的衛教，使個案在家屬的支持下能正向的面對疾病的衝擊，進而脫離藥癮的束縛並儘早回歸正常生活。期望藉此護理經驗提供臨床護理人員參考。

This article describes the nursing experience for a patient with spinal osteomyelitis secondary to drug abuse. The patient was suffering from pain and anxiety. The nursing period was from March 1 to April 15, 2010. Data were collected through observation, interview, and physical assessment using Roy's Adaptation Theory. The identified nursing problems were acute pain, existing infection, and anxiety following spinal surgery and drug abuse. At least four weeks were needed to treat spinal osteomyelitis. During the nursing period, the author established a good nurse -patient relationship through good listening skills and a caring attitude. The patient's pain and anxiety were alleviated through dependent and independent nursing interventions. The existing infection was under control using appropriate antibiotic therapy and patient education for infection prevention. The patient positively faced the impact of disease with family members' support, and further managed the issue of drug abuse to achieve a normal life. This paper can be used as a reference for clinical nurses who care for patients with the same diagnosis.