照顧一位青年創傷後左膝下截肢之護理經驗

A Nursing Experience of Caring a Post-trauma Young Adult Receiving Left Below Knee Amputation

經歷截肢要面對的是一個永久性的喪失，面對突如其來的改變，常造成生活及社交很大的衝擊，產生重大挫折與自卑。本文描述一位20歲之青年因創傷導致左膝下截肢之護理經驗。護理期間為2018年4月9日至5月11日，運用Gordon十一項健康型態功能評估，藉由觀察、傾聽、會談、身體評估、病歷資料查閱方式進行主客觀資料收集並分析整理，確立個案身心受創並產生急性疼痛、身體心像紊亂、身體活動功能障礙等健康問題，於照護過程中運用放鬆技巧減緩疼痛，給予關懷、心理支持，使個案接受身體外觀的改變，加上醫療團隊與家屬建立良好的支持系統，使個案正向的態度面對截肢的事實，重新適應日常生活自我照顧，因筆者於學生實習期間從沒有照護截肢個案，又是與自己年紀相仿的，畢業後初至臨床工作，第一次照護截肢的個案，期望藉此護理經驗分享，提供臨床護理人員照顧青年截肢病患之參考。

A person who encountered amputation had to deal with permanent bodily impairment. With the unexpected accident, it brought significant impacts on patient's life and interpersonal relationship and resulted in great frustration and feeling of inferiority. This paper described the nursing experience of caring a 20-year-old young adult who received left below knee amputation due to trauma. The nursing period began from April 9^(th) to May 11^(th) of 2018. Whilst Gordon eleven Function Health Patterns was administered, the data collection was subjectively and objectively conducted via observation, listening, interview, body assessment, and medical record review for analysis. It indicated that the patient suffered from physical and psychological trauma with comorbidity of acute pain, body image disturbance, and bodily function impairments. During the medical care, means of relaxation were applied to reduce pain level with caring and psychological support. In order to make the patient accept his physical change, a well supporting network was built between the medical team and patient's family to enable the patient to handle amputation with a positive attitude and to adapt to patient's daily life. It was my first clinical experience to provide nursing care to an amputated patient; therefore, I looked forward to sharing my experience to nurses on first line caring similar patients.