照顧一位脊柱側彎症青春期少女接受矯正手術之護理經驗

The Nursing Experience of an Adolescent Female Patient Undergoing Scoliosis Correction Surgery

本文係探討一位15歲少女，因特發性脊椎側彎入院行手術之護理經驗。護理期間自2021年2月15日至2月23日，藉由系統觀察、會談、傾聽、身體評估及查閱病歷等方式蒐集主、客觀資料，運用Gordon十一項健康型態進行評估，確立主要優先護理問題為：急性疼痛、焦慮及照顧者角色緊張。筆者感受個案及父母面臨手術的焦慮，藉與他們建立信任關係，術前即提供相關資訊並利用擴增實境（Augmented reality, AR）工具指導術前及術後的心肺功能訓練、下肢運動來預防肺部合併症，並引導個案及父母表達感受和澄清疑問減輕焦慮。提供手術後緩解急性疼痛方法、結合學校端解決住院課業擔憂，共同討論術後返家及返校將會面臨的狀況並協助解決之，且透過跨領域團隊全人醫療，增進正向因應技能，以達到全人全家照護。藉此更了解針對青少年發展之照護目標，建議可廣泛推展此族群中最感興趣之擴增實境（AR）動畫工具進行護理指導，來提升對於疾病認知及術後照護技能。期將此照護經驗分享，提供青少年就醫病人更完整的照護。

This article described the nursing experience of a fifteen-year-old female patient with idiopathic scoliosis receiving primary correction. Inpatient nursing care lasted from February 15 to February 23, 2021. Information was gathered through systematic observation, conversation, and physical evaluation and was assessed by Gordon’s 11 functional health patterns. The priority health issues were identified as acute pain, anxiety, and caregiver role strain. To reduce the anxiety of the patient and parents and lead them to express their emotions and questions, we establish a trusting relationship with the patient and caregiver, provide pre-surgery information and augmented reality（AR）tools to guide preoperative and postoperative cardiopulmonary training and lower limb exercise to prevent pulmonary complications. Also, we offer relief strategies for acute pain after surgery, solve schoolwork worries in the hospital, and discuss and assist in solving the situations that will be faced when returning home and school after surgery. Whole-person family care was achieved by enhancing positive coping skills and cross-disciplinary team health care. To better understand the care goals for adolescent development, it is suggested that augmented reality（AR）animation tools, which are most interesting to this group, can be widely promoted for nursing guidance to improve disease awareness and postoperative care skills. We hope that providing the nursing experience as the reference will provide better care for adolescent patients.