一位僵直性脊椎炎手術個案之照護經驗

A Nursing Experience of a Postoperative Patient with Ankylosing Spondylitis

本文是一位31歲男性因僵直性脊椎炎行五次手術之護理經驗。護理期間為2013年05月23日至10月29日，運用功能性Godon11項健康評估，經照護、觀察、會談、身體評估、查閱病歷及後續追蹤等方式收集資料，護理問題有自我照顧能力缺失、身體活動功能障礙、低自尊、焦慮等。過程中個案對手術產生焦慮，故衛教相關資訊，提供自我更衣沐浴的方式，以提升自我照顧能力及達成率。此外，經由手術及復建計畫，可自行抬頭挺胸行走，改善低自尊重新面對人生。因個案為當地的弱勢團體，導致延誤治療，故出院後，希望能結合社會資源及轉介於當地醫療團體，持續追蹤，並協助個案回歸正常生活。筆者期盼此經驗分享能提供日後照護類似個案之參考。

This article described the nursing experience of a 31 year-old male patient with ankylosing spondylitis with five prior surgeries. To provide a comprehensive nursing assessment of the patient, information were collected during the nursing period from May 23^(rd) to October 29^(th), 2013, via direct care, observation, interview, physical assessment, medical records and follow-up, and were evaluated by applying Gordon's functional health patterns. The nursing issues identified were self-care deficit, impaired physical mobility, low self-esteem, and anxiety. Anxiety, caused by the patient’s unfamiliarity with the surgical procedures, were reduced by providing relevant health educations. Teaching the patient to self-dress when bathing successfully improved its completion rate and raised the self-care capability. Surgeries and individualized rehabilitation plan allowed the patient to walk upright, which eliminated the low self-esteem. As a member of a local disadvantaged group, the patient was delayed treatment. To reduce the risk upon discharge, we integrated social resources, referred the case to a local medical organization, and provided consistent follow-up to aid the patient in returning to a normal life. The author shares the experience as a reference when nursing similar cases.