照顧一位青少年因多重創傷導致右眼失明之護理經驗

Caring for an Adolescent with Right Eye Blindness Due to Multiple Traumas

本文描述一位青少年因車禍導致多重性創傷，以致右眼失明，使得身心衝擊與對未來產生迷惘；另家庭中照顧者面對突如其來的變故感到不知所措與因應。護理期間為2021年10月23日至11月29日，筆者藉由觀察、傾聽、身體評估等方式收集相關資料，以Gordon十一項健康功能型態評估，確立個案有疼痛、感覺知覺改變、無望感及照顧者角色緊張等健康問題。照護期間給予合適的疼痛控制，透過跨領域醫療團隊協助，使個案逐漸敞開心胸，正向積極面對往後的復建之路，另針對照顧者面臨種種擔憂與壓力，予提供相關社會資源，出院時協助轉介至慢性復健醫院，使得家庭得以正常運作及個案能重新調適新的生活模式。建議醫療團隊可增加創傷個管師協助銜接相關資源需求之個案，以利了解出院個案之動向及後續返家照護狀況。希望藉此經驗分享提供護理人員照顧此類個案之參考。

This article portrays the case of an adolescent who experienced multiple traumas resulting from a car accident, leading to blindness in the right eye, causing significant physical and psychological impact, and fostering a sense of confusion about the future. Simultaneously, the family caregiver grappled with the sudden and overwhelming challenges brought about by this unexpected turn of events. The nursing care period spanned from October 23, 2021, to November 29, 2021. Employing observation, active listening, and physical assessments, the author collected relevant data and utilized Gordon's Eleven Functional Health Patterns assessment to identify health issues, including pain, altered sensory perception, hopelessness, and caregiver role strain. Throughout the care period, appropriate pain control measures were administered. With the assistance of an interdisciplinary healthcare team, the individual gradually opened up emotionally, facing the future rehabilitation journey with a positive outlook. Additionally, targeted support was provided to address the various concerns and pressures faced by the caregiver, including the provision of relevant social resources. Upon discharge, assistance was offered in facilitating a referral to a chronic rehabilitation hospital, enabling the family to resume normal functioning, and aiding the individual in readjusting to a new lifestyle. A recommendation for the healthcare team is to consider incorporating a trauma care coordinator to assist in addressing the resource needs of such cases, facilitating an understanding of post-discharge trends, and evaluating subsequent home care situations. This shared experience aims to provide nursing professionals with valuable insights into caring for similar cases.