照護一位左腳膝上截肢個案之護理經驗

Nursing Experience in Caring for A Patient with Left Above-Knee Amputation

本文描述一位個案因罹患周邊動脈阻塞疾病以致左下肢截肢的中年男性復健治療之護理照護經驗。筆者於2023年2月20日至3月31日照護期間，透過觀察會談、病歷查閱及直接照護等方式收集資料，運用Gordon十一項功能性健康型態評估，確立個案有身體活動功能障礙、身體心像紊亂、無力感等健康問題。藉由主動關懷、陪伴與個案建立信任之護病關係，提供個別性護理措施，偕同團隊與個案共同討論擬訂與執行復健活動計畫，強化個案肌肉力量來增加活動功能與訓練使用活動輔具，提升個案自我照護能力，並引導個案表達內心感受及主動參與自身照護、提供合適放鬆方法及給予關懷與傾聽，使個案維持自我價值感，並接受身體結構與功能的改變，提升個案接受復健治療的信心與希望，增加復健動力，進而改善個案存有之健康問題。照護期間照會出院準備協助轉介及提供後續出院復健計畫，使個案適應截肢後生活回歸社會。期望藉此護理經驗分享，提供臨床護理照護此類病人之參考。

This article describes the nursing care experience in the rehabilitation treatment of a middle-aged male patient who underwent left lower limb amputation due to peripheral arterial occlusion disease. During the care period from February 20th to March 31st, 2023, data was collected through observations, interviews, medical record reviews, and direct care, etc. Utilizing Gordon's eleven functional health patterns assessment, identified the patient's health issues as Impaired physical mobility, body image disturbance, and powerlessness. Through proactive care and companionship, a trusting nurse-patient relationship was established. Individualized nursing measures were provided, and the team collaborated with the patient to discuss, develop, and implement a rehabilitation activity plan, aimed at strengthening the patient’s muscle strength to enhance activity function and training in the use of assistive devices, thereby improving the patient’s self-care abilities. Guide the patient in expressing their inner feelings and actively participating in their own care, provide appropriate relaxation methods, and offer care and listening, helping the patient maintain a sense of self-worth, and accept changes in body structure and function, enhance the patient’s confidence and hope in rehabilitation treatment, increase motivation for rehabilitation, and thereby improve the patient's existing health issues. During the care period, discharge planning was provided to help the patient adapt to life after amputation and reintegrate into society. It is hoped that this nursing experience will offer a reference for clinical nursing care of similar patients.