應用歐倫（Orem's）理論照顧一位新型隱球菌腦膜炎患者之護理經驗

Applying the Orem's Self-care Theory to Care Inpatients with Cryptococcal Meningitis

本文是描述一位十九歲腦膜炎合併水腦之患者，因腦膜病變而有頭痛、嘔吐、認知與行為等神經心理性障礙。護理個案期間為89年8月1日至11月5日，筆者以會談及觀察的方式收集資料，經由歐倫自我照顧系統理論的評估，確立個案有舒適情況改變、思考過程改變、日常生活自我照顧能力缺失、個人因應能力失調及案母有照顧者角色緊張等護理問題。經應用歐倫護理理論的完全代償、部份代償及支持教育護理系統，提供患者各項護理措施，緩解腦膜刺激症狀及利用認知訓練促進個案對疾病的認知改善，而能以漸進式參與自我照顧的訓練；增加個案對壓力的因應能力，協助案母壓力的緩解，更促進個案母子關係的建立及情感依附，使能在三個月內增強其自我照顧能力而順利出院返回家庭。

This is a nursing case report about a 19 year-old male with Cryptococcal meningitis .The patient was suffering from hydrocephalas that induced headache、vomiting and cognitive-behavior disturbance. During his hospitalization from Aug.1to Nov.5,in 2000, nursing assessment data were collected through physical examination、observation and interview. Based on Orem's Theory, health problem identifications included physical comfortable condition alterations、thought processes alterations、self-care deficit、ineffective individual coping、and caregivers' role strain, then wholly and partly compensatory and supportive-educative three nursing systems were provided. Three months later, not only the patient's self-care ability was improved, but also the interaction between the mother and the child was enhanced, and the patient eturned to his family and social life smoothly.