一位年輕型腦中風病人之護理經驗

Nursing Experience of Caring a Young Stroke Patient

腦血管疾病位居國人十大死因第四位，對於病人生心理的影響甚鉅，亦會改變一個家庭的發展。本文描述一位28歲年輕男性罹患出血型腦中風，接受外科顱骨切開術移除血塊後之護理經驗。照護期間於2018年11月12日至11月30日，運用Gordon十一項健康功能型態為指引，確立主要健康問題為「身體活動功能障礙」、「組織完整性受損」與「焦慮」。個案正值人生最精彩時刻，因疾病衝擊導致對未來產生焦慮不安，引發筆者撰寫動機，運用個案熟悉的香氛精油，緩解焦慮情緒；密切觀察開顱傷口，並預防感染；引導採漸進式增加肢體活動力，積極參與急性後期照護計畫。由於本院目前沒有復健治療決策輔助工具及相關教育訓練，建議未來能增加醫療決策輔助工具與推廣教育訓練，提升醫病間的溝通，帶給個案與家屬更加完善的照護。

Cerebrovascular disease is currently the fourth leading cause of death in Taiwan. It has a profound impact on the patient's physiology and psychology, and will change the future development of a family's life. This article described the nursing experience of caring a 28-year-old young man suffering from hemorrhagic stroke, after undergoing surgical craniotomy to remove blood clots. The care period was from November 12 to 30, 2018. Using Gordon's eleven health function patterns as a guide, we identified the health problems as 'physical activity dysfunction', 'impaired tissue integrity', and 'anxiety'. We used familiar essential oils to relieve anxiety; closely observed the craniotomy wound; and assisted the patient gradually increase physical activity and actively participate in the acute post-care care plan. In view of the fact that there has been no decision-making aids for rehabilitation treatment and related education and training in our hospital, it is recommended that in the future, medical decision-making aids and promotion of education and training can be added to improve communication between doctors and patients to establish a comprehensive care to patients and their families.