照護一位腦中風復健個案之照護經驗

Nursing Experience for A Patient with Stroke Rehabilitation

本文敘述一位70歲女性腦中風復健個案之護理經驗。護理期間自2022年9月13日至2022年10月7日，運用Gordon十一項功能性健康型態評估，藉由觀察、會談及身體評估等方式進行整體性評估後確認個案有身體活動功能障礙、吞嚥障礙、無力感之護理問題。文中個案因腦中風意外造成生活型態及身體活動功能改變，無法獨立處理日常生活，需要別人照顧，生活品質大幅降低，及擔心增加家庭負擔等，引發筆者想深入探討。照護期間藉由適時表達對個案的關懷及同理，建立良好的護病關係，使個案願意分享及抒發內心感受，增加對治療的自信，運用專業知識及技能，使用彈力帶床邊復健技巧及鼓勵參與日常生活活動等方式，提升自我照護意願及能力，使用吞嚥訓練流程使個案能逐漸恢復吞嚥功能，並配合音樂治療、腹式呼吸及漸進式肌肉放鬆技巧讓個案可以緩解無力感、失望情緒放鬆自己，減少復健治療引起的肌肉緊繃感，透過鼓勵家庭成員及照顧者給予正向支持，增加對於復健治療的配合度及意願。建議護理人員運用專業的護理知識結合復健技巧，促進患者的復健計畫，期望藉由此經驗分享，提供臨床護理人員照顧此類個案依據，增加臨床實務之參考，有助於達到更完善的護理品質。

This article presents the nursing experience of a 70-year-old female stroke rehabilitation patient. The nursing period was from September 13, 2022, to October 7, 2022. The Gordon's 11 Functional Health Patterns to collect date and through observation, interviews, and physical assessments, overall assessments confirmed the patient's nursing problems, including impaired physical activity, swallowing difficulties, and Powerlessness. The stroke led to lifestyle and functional changes, necessitating assistance and resulting in reduced quality of life and increased family burden. Timely care and empathy established a good nurse-patient relationship, promoting the patient's expression of feelings and confidence in treatment. Bedside rehabilitation techniques using elastic bands and encouraging participation in daily activities were employed to enhance the patient's willingness and ability for self-care. Swallowing training procedures were used to gradually restore swallowing function, while incorporating music therapy, diaphragmatic breathing, and progressive muscle relaxation techniques to help the patient alleviate anxiety and muscle tension caused by rehabilitation. Positive support from family and caregivers increased cooperation in rehabilitation. Nursing professionals should integrate nursing expertise with rehabilitation techniques for effective patient care. It is hoped that by sharing this experience, it can provide a basis for clinical nursing care of similar cases, increase references for clinical practice, and contribute to achieving a more comprehensive quality of nursing care.