應用背部按摩方案促進加護病房病患之睡眠品質

Applying Back Massage Protocol to Promote an Intensive Care Unit Patient's Quality of Sleep

本文為應用背部按摩於一位加護病房病患睡眠品質的護理經驗，照護期間為2005年5月10日至5月16日，照護期間筆者利用觀察、會談、Richards-Campbell睡眠量表（Richards-Campbell Sleep Questionnaire, RCSQ）等評估技巧，收集個案在加護病房期間睡眠品質之情形，發現個案睡眠品質較差，故提供個案「背部按摩」方案。經過背部按摩後發現，個案在心跳、呼吸、血氧飽和濃度及血壓方面沒有明顯改變，可能與個案擔心拔除氣管內管有關。但在主觀的睡眠感受方面，卻有明顯的改善，可能與個案感受到舒適及護理人員的關懷有關。因此，背部按摩在重症病患的睡眠品質上可能是有幫助的，希望藉由本個案報告提供醫護人員參考，並能將此措施應用於臨床，使病患在加護病房期間能獲得足夠的休息與睡眠，以期有足夠精力復原。但因本報告只用於單一個案，故建議未來能將此方案在多數的加護病房重症病患進行研究，以瞭解背部按摩方案對其睡眠品質之成效情形。

This case report concerns the nursing experience of applying back massage to a patient in an intensive care unit (ICU) from 10 May to 16 May, 2005, in order to improve the patient's quality of sleep. In order to collect information about his quality of sleep of the patient, the author used observation, interview, and a Richards-Campbell sleep questionnaire (RCSQ). It was observed that, before massage, the patient's sleep quality was poor, which was why the protocol with back massage was proposed. The results after back massage was applied that heart beat, respiration, oxygen saturation, and blood pressure were not significantly improved. This was probably related to the patient's worry about having his endotracheal tube removed. The patient's perception of sleep, indeed, was obviously improved, a result which may have been related to his/her perception of comfort and care from the nurse. Applying back massage to an ICU patient may therefore be regarded as helpful to improving the patient's sleep quality. It is hoped that this case report may serve as a positive reference for health care providers so that it may help patients to recover fully through rest and sleep. Since this report concerned only one patient, however, to understand the real outcome of how back massage could improve the quality of sleep of ICU patients, research is planned on the use of back massage protocol on a large number of such patients.