一位出血性腦中風病患之護理經驗

Nursing Experience with a Hemorrhagic Stroke Patient

本篇個案報告敘述一位 68 歲女性，因罹患出血性腦中風導致右側肢體偏癱，第二次入院復健時所面臨身體失能及無力感的情況。照護期間於2011 年4 月23日至2011 年5 月17 日，筆者以Gordon 十一項健康功能型態評估作為護理評估引導工具，與個案及家屬開放性會談、利用觀察及身體評估，蒐集主客觀資料，歸納出三項護理問題：身體活動功能障礙；自我照顧能力缺失及無力感。護理過程中，個案因進步緩慢，心情陷入低落、筆者以關懷、傾聽態度，與個案建立良好護病關係，導正其負面情緒及對目前功能障礙的認知，藉此護理經驗分享，強調腦中風後三個月內的復健黃金時期，護理人員應積極鼓勵病人參與復健治療，以期早日達到日常生活的最大獨立功能。

This case report presents a 68-year-old female suffering from physical dysfunction and powerlessness due to a hemorrhagic stroke with right hemiplegia during her second time of the rehabilitation. The authors used Gordon’s 11 Functional Patterns as an evaluation tool to discuss issues with the patient and family and make conclusions from three nursing questions by clinical observation, physical assessment, and collection of subjective and objective findings from April 23th, 2011 to May 17th, 2011. Finally, the authors highlighted three symptoms including physical function impairment, lack of self-care ability, and powerlessness. During hospitalization, the patient was noticed to have felt upset because of the slow progress in her right limbs functional impairment. We built up a good nursing and patient relationship with the patient through caring and listening, and guided her toward positive thinking and more understanding of her current impairment. By sharing the authors’ nursing experience based on the golden time for rehabilitation within three months, it is hoped that nursing staff would assertively encourage patients to participate in rehabilitation programs to reach the maximum healing effect, and achieve independence in daily life.