運用音樂療法減輕骨科術後病患急性疼痛之護理經驗

Nurse's Experience of Using Music Therapy to Relieve Acute Pain in a Post-Orthopedic Surgery Patient

本文描述護理人員運用音樂療法作為輔助療法，以減輕一位骨科手術後個案換藥時的急性疼痛，進而減少其負向情緒之護理經驗。護理期間自97年4月8日至29日止，運用羅氏適應模式評估，確立個案最主要的健康問題為急性疼痛，進而運用門戶控制理論(gate control theory)再加以深入評估急性疼痛的感覺、情感、與認知層面，完整呈現個案疼痛問題。筆者採用被動式的音樂療法，使個案能減輕疼痛、焦慮及增進正向的心理感受，進而達到身、心的舒適和健康。期能藉此成功的照護經驗提供第一線護理人員在照顧術後個案的參考，以有效減緩疼痛，增進舒適，並提高生活品質。

This article describes the experience of a nurse who used music therapy as the intervention to reduce a patient's pain during wound care after orthopedic surgery. The intervention was applied between April 8th and April 29th 2008. The nurse applied Roy's adaptation model as the assessment tool. The major and primary health problem identified was acute pain accelerated by wound care. The pain of this client not only triggered negative feelings, but also affected negatively on his daily life and feelings of self-belongingness. Through an individual-tailored music therapy, the client's pain during wound care was greatly reduced and even completely disappeared. The ultimate outcome of decrease in pain included reductions in negative feelings and increased positive spiritual strength. It is recommended that nurses who are responsible for wound care use this simple and economical music intervention to reduce acute postoperative pain.