獨居重症燒燙傷病人復健期併無力感之照護經驗

Experience of Caring a Patient with Severe Burn who was Alone and Powerless to Cooperate during the Rehabilitation Period

本文探討一位獨居重症燒傷病人復健期併無力感之護理經驗。筆者於2020年7月10日至11月14日期間，於復健期運用Gordon十一項功能性健康型態評估，藉直接護理、身體評估、觀察及會談等方式，確立個案有疼痛、活動功能障礙及無力感等健康問題；運用非藥物及藥物疼痛控制，減緩疼痛，邀請個案共同參與討論每週復健計劃，提供個別復健活動，透過跨專業團隊合作，充分溝通相互支持，建立良好護病關係，深入了解個案，引導個案表達內心無力感受，讓家屬參與護理措施及出院照護方式，增強個案自信心及勇於面對挑戰，適時提供轉介相關資源協助，最終達成出院目標，順利轉歸並銜接出院準備服務。

We described the nursing experience of caring a patient with severe burn patient who was alone and faced challenges in participating actively during the rehabilitation period. From July 10th to November 14th, 2020, the author was involved in the comprehensive care plan, spanning from the acute stage to the rehabilitation stage of the patient's recovery journey. We employed Gordon's 11 Functional Health Patterns to assess the patient's condition. Through careful data collection, we identified several health issues affecting the patient, including pain, physical activity dysfunction, and feelings of powerlessness. Our first step involved implementing a pain control protocol to alleviate the patient's discomfort. We also actively engaged the patient in discussions regarding weekly rehabilitation plans, tailoring them to his specific needs. Furthermore, through effective collaboration within an inter-professional team, we fostered a strong nurse-patient relationship. This was achieved by gaining a deep understanding of the patient's emotions, facilitating open communication for the patient to express his feelings, involving the family in the care process, discussing post-discharge care strategies, enhancing the patient's self-confidence for rehabilitation, and ensuring the timely referral of pertinent resources and support. We successfully achieved the goal of discharge, facilitating the patient's transfer to a community rehabilitation center.