運用羅氏適應模式於福耳尼埃氏壞疽個案之照護經驗

Application of Roy's Adaptation Model When Caring for a Patient With Fournier's Gangrene

本報告探討一位福耳尼埃氏壞疽(Fournier's gangrene)患者所面臨的生理、心理問題之照護經驗。筆者經由觀察、直接照護等方式，運用同理心、陪伴和關懷建立良好護病關係，並以羅氏適應模式，評估病患並確立護理問題，問題依時間發生之優先順序為：潛在危險性感染、體液容積缺乏、腹瀉、自我照顧能力缺失、焦慮、疼痛、身體心像改變等七項，針對影響病患適應程度的行為及導因，擬定整體性護理計畫，以改善病患之適應困擾，增加達成適應的目標及最好的健康狀態。僅將此護理經驗供予大家分享，盼對往後照護此類患者有所助益。This article describes the application of Roy's adaptation model when caring for a patient experiencing physical and psychological changes associated with Fournier's gangrene. The Roy's model guided the assessment of the patients' levels of adaptation and facilitated the management of stimuli to promote their adaptation. Nursing interventions focused on issues surrounding Fournier's gangrene, including in time sequence: high risk for infection, fluid volume deficit, diarrhea, selfcare deficit , anxiety, pain, and body image disturbance. The nurse helped the patient make adaptive responses to these stimuli through nursing interventions. This caring experience may help nurses provide comprehensive nursing care when caring for patients with similar diseases or problems.