運用復能照護一位梗塞型腦中風住院病人的護理經驗

本文描述運用復能照護一位梗塞型腦中風病人之護理經驗，筆者在2020年4月15日至4月22日照護期間，經由直接照護、觀察、會談及身體評估等方式收集主客觀資料，發現病人左側額葉梗塞型中風，影響平衡、雙手掌活動度及手指肌力，無法獨立自我照顧，且因單身獨居，支持系統薄弱，對未來感到徬徨無助，故確立病人有「身體活動功能障礙」、「高風險性跌倒」及「無助感」三個主要健康問題。透過漸進式的運動復健與輔具的應用，將訓練融入生活，幫助病人能順利發揮最大的功能性能力，改善身體活動功能障礙及高風險性跌倒的問題；同時亦重建病人對於疾病的認知，增加自我疾病的控制，以解決病人的無助感。整個過程顯示在照護此類病人時，護理人員應協助病人將有限的能力發揮到最大，以助達到復能之最大極限。期望藉由分享此次護理經驗，作為未來臨床護理人員照護此類病人之參考。

This article presents a nursing experience involving the application of reablement methods in caring for a patient diagnosed with cerebral infarction. The nursing care period spanned from April 15th to 22nd, 2020. Through direct care, observation, interviews, and physical assessments, subjective and objective data were collected, revealing the patient's poor mobility in hands, muscular weakness, and diminished sensation in the fingers. Consequently, the patient exhibited limited functional activities of daily living and self-care abilities. Additionally, being single and living alone contributed to a relatively weak support system, resulting in three major health concerns: ''physical dysfunction,'' ''high risk of falling,'' and ''helplessness.'' By incorporating progressive exercise rehabilitation and the use of assistive devices integrated into daily life, the patient's training aimed to maximize functional ability and address issues of physical dysfunction and fall risk. To mitigate feelings of helplessness, the author focused on rebuilding the patient's disease knowledge and enhancing self-management skills. It is recommended that nurses actively engage in rehabilitation programs and their practical application when caring for such patients. Through this approach, patients can optimize their limited abilities and achieve the maximum benefits of reablement. The author hopes this nursing experience serves as a valuable reference for clinical practice, guiding nurses in the care of similar patients in the future.