照護一位顏面燒傷合併視力損傷個案之加護經驗

An Intensive Nursing Experience about Caring a Facial Burn Patient Combined with Visual Impairment

本文描述照護一位因工作引起顏面燒傷合併視力損傷青壯年之加護經驗。依據生理、心理、社會、靈性層面進行護理評估，藉由觀察、會談及實際照護來收集資料，確立個案有組織完整性受損/與燒傷導致臉部及雙手皮膚受損有關、急性疼痛/與燒傷傷口執行水療及換藥有關、焦慮/與擔心視力及肢體功能無法恢復有關等健康問題。照護期間由2012年5月23日至6月7日，筆者與跨團隊專家討論，提供實證為主介入措施，使得個案燒傷傷口逐漸癒合，並採主動關懷、傾聽及陪伴、實際經驗分享並接納個案心中感受及情緒反應等措施，以減輕個案在治療期間之不確定感，並增加與醫療人員間之信任感及自我安全感以降低焦慮，使個案逐漸恢復視力，重拾信心回歸職場，同時以正向態度來面對此創傷過程。期望藉由此護理經驗之分享，能提供護理人員對於燒傷病人照護之參考。

We reported an intensive care experience on a young adult who had suffered from facial burn combined with visual loss at work. According to physio-psycho-socio-spiritual manifestations, we evaluated the patient by means of observation, interview and daily nursing work to collect data. We confirmed that the patient had health problems such as impaired tissue integrity (related to facial and bilateral hands burn injury), acute pain (related to changing dressing and hydrotherapy for burn wound), and anxiety (related to functional restoration of visual acuity and limbs functions). The nursing period was from May 23th to June 7th in 2012. We discussed with panel experts from multiple fields and offered evidence-based nursing intervention, promoting the burn wound healed. We also provided active caring, hearken listen, accompany, and real nursing experience sharing to the patient and accepted his emotional reaction in order to reduce the uncertain feel during the therapeutic period. It also increases nursing confidence, self-esteem in patient, and lower the anxiety. Improving in visual acuity, patient goes back to work confidently and face the injury positively. We hope to share this valuable experience to stuff in burn injury care.