一位頸脊髓損傷病人的照護經驗

A Nursing Experience of a Patient with Cervical Spinal Cord Injury

本文敘述一位40歲男性因車禍導致頸椎椎間盤破裂合併脊髓損傷患者的照護經驗。護理期間為2014年9月4日至2014年9月25日，筆者依據歐倫理論執行護理評估，藉由觀察、會談、傾聽及出院後電訪等技巧來收集資料，確立個案主要健康問題有：手術後急性疼痛、身體活動功能障礙、排尿障礙及無望感等護理問題；運用疼痛量表評估病人疼痛程度，指導個案及家屬利用放鬆技巧、肢體按摩等非藥物處理方式及藥物處理方式，達到疼痛緩解之目的；提供膀胱訓練、肌力訓練及共同擬訂復健目標，維持身體活動功能、增加肌肉強度、預防跌倒；引導個案表達內心感受，強化個案正向自我概念，協助回歸正常社會化生活，期望藉此經驗作為日後護理人員照護此類個案之參考。 This article describes the nursing experience of a 40-year-old male patient with cervical rupture and spinal cord injury as a result of an automobile accident. The author performed nursing assessment based on the Orem self-care deficit theory, and collected data via observation, discussion, listening, and follow-up phone interviews. The following main health issues were confirmed: postoperative acute pain, physical activity dysfunction, dysuria, and hopelessness. The following strategies were devised and implemented to address the patient’s health issues: relieve the patient’s acute pain by first assessing the patient’s level of pain via pain scale, and subsequently instruct the patient and family to utilizing relaxation techniques, massages, and medication; provide bladder training, muscle strength training, and draft a mutual rehabilitation goal to maintain the patient’s physical activity, enhance muscle strength, and prevent falling; and guiding the patient to express inner feelings, enhance positive self-concept to reintegrate into society. We hope that this nursing experience can serve as a future reference for nursing staff with similar cases.