一位主動脈剝離術後病人之重症護理經驗

A Nursing Experience of an Aortic Dissection Patient in an Intensive Care Unit After Surgery

本文在描述一位診斷A型主動脈剝離病人，術後於陌生環境，而感到生命被迫威脅之護理經驗。照護期間為2013年10月14日至10月16日，藉由觀察、會談、身體評估及直接照護等方式，採用羅氏適應模式進行整體性的護理評估，確立評估病人有急性疼痛、睡眠型態紊亂、焦慮、情境性低自尊等健康問題。在護理過程中，筆者提供符合病人之護理措施，協助處理生心理問題，有效促進病人自我調適，協助度過於加護病房術後焦慮的過程，發揮護理的專業角色及技巧，藉由照護過程中以提供護理人員在其專業領域上照護的參考。建議未來重症單位可增設相關影音設備，讓病人與家屬進行通訊增加其安全感。

This article described a nursing experience of a patient, diagnosed with aortic dissection type A, who felt life threatening when being placed in ICU, an unfamiliar environment, after surgery. The nursing period lasted from Oct. 14 to 16, 2013. The author applied Roy’s Adaptation Model and conducted a comprehensive nursing assessment via observation, interview, physical evaluation and direct nursing. The following health issues were identified: acute pain, sleep pattern disturbance, anxiety and situational low self-esteem. During the nursing period, the author provided nursing measures appropriate for the patient, assisted her with physiological and psychological issues, facilitated self-adaptation, accompanied her to overcome postoperative anxiety while in ICU, and offered professional nursing advices. It is recommended to set up audio-video equipment in trauma unit to allowing patients and families to communicate via video conference, and therefore increase patients' sense of security.