結合中、西醫療法於便秘導致腸阻塞住院老人之護理經驗

The nursing experience of using Chinese and western medical treatment to an in-hospital elderly resident with intestinal blockage constipation

本篇個案報告描述運用穴位按摩療法改善一位老人因便秘導致腸阻塞住院之護理經驗。護理期間為2013年4月4日至10日，運用老人周全性評估七大軸向進行護理評估，確立個案的主要健康問題有：「便秘」、「疼痛」與「焦慮」。在照顧過程中，筆者依實證文獻結果，採用多項合併護理措施，如適度增加水分、運動和纖維攝取量並採取中醫穴位按摩等方式，改善個案因關節退化導致活動力降低造成腸蠕動變慢，使得便秘加劇引發腸阻塞而住院的問題。現況臨床上多以藥物治療老人便秘問題，但藥物治療不但增加老人生理負擔，也可能因藥物間交互作用產生後遺症。此個案經由應用中醫穴位刺激的原理成功改善個案便祕情形，獲得個案及家屬的肯定。建議臨床護理人員可以將非藥物方式列為處理老人便秘問題的策略之一。希望藉分享此護理經驗，建議護理人員能善用獨立性護理措施於類似個案照顧上。

This case report describes the nursing experience of using acupressure therapy for ileus caused by constipation inan elderly patient. The nursing period was from April 4, 2013 to April 10, 2013. We used seven components of theComprehensive Geriatric Assessment as a tool for the nursing assessment and identified that the patient’s healthproblems were constipation, pain, and anxiety. In the nursing process, the researcher combined Chinese and westernnursing interventions, such as moderate increase on water, exercise and fiber intake, and acupuncture point massage toimprove the case’s constipation resulting in intestinal blockage due to joint degeneration leading to energy decreasingand slower peristalsis. Currently, drug therapy is used clinically to remedy the elderly constipation problem. However,drugs not only cause the burden on the elderly physiology but also bring about sequelae due to the interactions amongdrugs. By applying the principles of acupuncture point stimulation, this case and her family successfully improvedconstipation and reconstructed the recognition of constipation. In view of this, it is highly recommended to list non-drugintervention in the strategies of dealing with elderly’s constipation. By sharing this nursing experience, we hope thatnursing staff can take advantage of independent nursing methods on similar patients in the future.