照顧一位瀰漫性軸突損傷病人之護理經驗

Nursing Experience of Caring for a Patient with Diffuse Axonal Injury

本文是照顧一位瀰漫性軸突損傷的28歲個案。突發意識變化、感覺及知覺錯亂，讓主要照顧者不知所措之護理經驗。護理期間，筆者執行護理評估，歸納個案健康問題：感覺與知覺紊亂、吞嚥障礙及照顧者角色緊張等。護理過程介入包含多重感覺刺激以恢復個案合宜的表達與動作；與語言治療師合作進行吞嚥訓練，協助主要照顧者出院後持續協助個案進行吞嚥訓練；運用成功照護經驗個案之人型圖、圖畫時鐘協助了解疾病進展及預後，及規劃每日照護之流程，協助個案早日回復日常活動功能。藉由此護理經驗，提供臨床護理人員在日後照護類似病患時之參考。

This case report describes the experience of caring for a 28-year-old man with diffuse axonal injury (DAI). During hospitalization, the patient experienced sudden altered consciousness and sensory disturbance, which resulted in caregiver role strain. Problems during the nursing period included disturbed sensory perception, impaired swallowing, and caregiver role strain. To promote the patient's recovery of daily activity, interventions for the patient and caregiver were planned separately. The intervention for the patient included multisensory stimulation and swallowing training. To promote the caregiver's knowledge of the disease course and improve the caregiver's daily nursing skill, we employed a humanoid diagram and clock drawing exercise. Our experience described herein can help promote recovery in patients with DAI and assist overwhelmed caregivers.