照顧一位壞死性筋膜炎個案之護理經驗

Nursing Experience in Caring for A Case of Necrotizing Fasciitis

本文探討一位糖尿病併發壞死性筋膜炎個案之照護經驗。照護期間為2018年4月29日至5月7日，筆者以觀察、會談、身體評估及病歷查閱等方式收集資料，運用Gordon十一項健康功能型態評估，確立個案有急性疼痛、組織完整性受損、身體心像紊亂健康問題。護理期間提供深呼吸放鬆技巧及音樂療法相關措施緩解急性疼痛問題，提供心理支持，引導個案偕同家屬共同參與護理照護過程，以正向態度面適應疾病及面對身體的改變。針對個案護理經驗中的建議照護這種病人時，應同時著重生理與心理之照護，以協助正向的疾病適應，期望改善照護經驗分享，提供後續護理人員照顧此疾病之參考。

This study demonstrated the experience caring a 43-year-old male patient with diabetes complicaed with necrotizing fasciitis. The caring period was from April 29 to May 7, 2018. Data was collected through the observation, conversation, physical evaluation, medical records, and the researcher adopted Gordon's 11 terms caring theory from the patient, to assess and confirmed the condition of acute pain, impaired tissue integrity, and body image disturbance. The patient’s pain was alleviated through deep breath relaxation exercises and music therapy to relieve ongoing wound care. Invite the family members to share their opinions, and help the patient express his feelings are. Recommended in caring this kind of patients. The caregiver should focus on both physical and psychological care reduce psychological impacts, and improve disease adaptation return to healthy status. This study provides some experiences for future clinical practice.