照顧一位脊柱側彎之青少年病患接受脊椎手術的護理經驗

An Experience of Taking Care of an Adolescent Spinal Surgery Patient Suffering from Scoliosis

本報告係描述照顧一位正值青少年期的19歲少女，因特發性脊柱側彎而需接受脊椎手術治療的經驗。筆者主要運用觀察、一對一個案會談，以及應用Gordon十一項功能性健康型態進行評估，患者因未曾有過手術經驗，加上面臨身體外觀的改變，導致術後產生急性疼痛、自我照顧能力缺失、焦慮及身體心像紊亂等身心問題。過程中除運用專業知識及技能，協助個案緩解手術所引起之生理不適；且採持續性的關懷、傾聽並以同理心鼓勵個案說出內心的感受，使其情緒能適當發洩；亦藉由護理人員及家屬之關心與支持，使個案激發起自我學習照顧的動機，以及接受身體心像的改變，克服疾病所帶來的衝擊。經由護理此個案，深刻體會護理人員在照護病患時，惟有適切地給予個別性及整體性的護理指導，深入瞭解其所面臨的身心問題，方能發揮護理獨特的功能。

This case report describes the experience of taking care of an adolescent (nineteen year-old) girl, who needed spinal surgical treatment because of scoliosis. The author assessed the patient’s condition by observation, interview, and the Gordon 11-item functional health pattern assessment guide. Because she had had no previous surgical experience, and faced changes in her bodily appearance, the adolescent had physical and psychological problems, such as acute pain, self-care deficit, anxiety, and body image disturbance. Besides applying professional knowledge and technical ability, to alleviate the discomfort caused by the young lady's surgery, the author used caring, listening and empathy to encourage and support her in learning self-care, to accept her change in body image, and to overcome the impact of the disease. Through this nursing process, the author came to understand that nurses must concern themselves with both physical problems and mental needs in order to provide holistic health care.