照顧一位腦中風病人之護理經驗

Nursing Experience of Caring a Patient with Cerebral Vascular Accident

本篇個案報告是敘述一位55歲男性腦中風病人，因右大腦血管梗塞導致左側肢體偏癱，面臨疾病所帶來身體失能情況其主要照顧者面對獨立照護病人，產生角色緊張的問題。筆者護理期間自2015年5月28日至2015年6月26日，運用觀察、會談、直接參與照護等方式收集資料，並以Gordon十一項功能評估為基礎，確認病人與主要照顧者在住院期間所呈現的健康問題有：1.身體活動功能障礙、2.個人因應能力失調、3.照顧者角色緊張。於護理過程中，筆者先與病人和主要照顧者建立信賴的治療性人際關係，並運用傾聽與引導技巧，轉介背景相似復健成功案例，減輕對疾病的不安與困惑，增進對治療計劃的配合度，透過病人與復健團隊共同制定復健計畫，增進其身體活動功能，主要照顧者方面，藉由會談及關心，及提升疾病照護相關技能，降低主要照顧者照護技能不足及角色轉換的擔憂。期望透過此病人護理經驗的分享，作為日後照護此類病人之參考，使護理人員獨特角色功能得以發揮。 This case report describes a 55-year-old male patient who suffered from right cerebral artery infarction with left hemiplegia. The main problem is that the patient faced the roles strain with his caregiver, who is the only one caregiver to take care of him. During this period from May 28 to June 26, 2015, we used ways of techniques of observation, communications, and talks directly involved in care to collect data. By Gordon eleven functional assessment, the main healthy problems are 1. Physical Activity Dysfunction, 2. Ineffective Individual Coping, 3 Caregiver Roles Strain. In nursing process, We followed the guideline established to build a trust and therapeutic relationship between patients and their caregivers. established the trust and therapeutic relationship with patients and caregivers. by using of listening skills and referral background similar rehabilitation success stories to alleviate anxiety and confusion of the disease, the plan to enhance cooperation degree, Through the patient and the rehabilitation team to develop rehabilitation plans, physical activity function were increased. For caregivers, we reduced the skills shortage of caregivers and the concern of role reversal with communicating, talking care of patient, and enhancing disease-related skills. At last, We hope that through sharing this nursing experience, and nurses can play their unique roles in the future.