簡尼特手術患者手術全期護理與Orem理論之運用

Application of Perioperative Nursing and Orem's Theory on a Patient with Jannetta's Operation

本文主要探討一位左邊顏面痙攣患者接受簡尼特手術運用手術全期護理與Orem理論文照護過程。在手術前、中、後期透過觀察、訪談、傾聽及身體評估等方式收集資料，手術前期，個案因面臨手術產生焦慮，此時提供支持與教育性護理；手術中期，個案在深度麻醉下完全失去自我照顧能力，給予完全代償性護理的照護；手術後期，個案因術後不當環境刺激，造成睡眠型態紊亂，此時則提供部份代償性護理；恢復期中，在個案及家屬面臨傷口及出院的自我照顧，給予支持與教育性護理。在整個照護過程中，協助個案改善焦慮不安的情緒，有信心的接受手術，安全渡過整個手術過程，提昇手術後自我照顧能力。謹撰此文期能提供手術全期護理人員照護此類患者之參考。

The purpose of this study was to discuss the application of perioperative nursing and Orem's theory on a left facial spasm patient who received Jannetta's operation. Data were collected by observing, interviewing, listening, and physically assessing during intraoperative nursing care and four preoperative and postoperative interviews. During the perioperative nursing period, we provide preoperative supportive-educative nursing, intraoperative fully compensatory nursing, postoperative partially-compensatory nursing and supportive-educative nursing.By the practice of perioperative nursing, the anxiety of the patient was reduced, safely and smoothly throughout the surgery, and he obtained the ability of self-care after discharge. This study will be of interest to perioperative nurses as a reference in caring for similar patients.