一位復健期腦中風病人因應疾病過程之護理經驗

The Nursing Experience in Caring for a Stroke Patients with Coping the Disease Process During the Rehabilitation Period

本文敘述一位82歲復健期腦中風病人因應疾病之護理經驗，個案在2010年11月26日至2011年1月3日，筆者透過觀察、會談、身體評估及運用Gordon十一項健康功能評估等方式收集相關資料，發現個案在神經肌肉受損後，頓時無法接受功能障礙及生活的改變而產生情緒導向因應行為，故確立個案有吞嚥障礙、身體活動功能障礙、個人因應能力失調之健康問題。在建立良好治療性人際關係後，透過傾聽、關懷與個案及家屬共同討論復健計劃，使個案能正向因應疾病並積極投入復健治療，以維持肢體殘存功能並使吞嚥障礙與疾病壓力能獲得改善。護理人員除了給予疾病照護與鼓勵病人配合復健治療外，更深入心理層面了解個案與家屬的需求，給予情緒支持與抒發，使護理趨於全人照護，更提升了護理品質。

The case report describes an 82-year-old female stroke patient and coping disease process during the rehabilitation period. From November 26, 2010 to January 3, 2011, the author applied several measures for data collection and analysis, such as observation, conversation, physical evaluation and Gordon’s 11 functional health patterns to this case. The researcher found the patient had neuromuscular damage after stroke and thus, was having trouble dealing with the fact of future life changes and partial dysfunctions of bodily movement. The patient’s nursing issues included: (1) impaired swallowing; (2) impaired physical mobility; and (3) ineffective individual coping. Through proactive listening and caring, after establishing a good therapeutic relationship with the patient and family members to discuss the rehabilitation program so that the case could be a positive response to the disease, and by becoming actively involved in rehabilitation in order to maintain residual limb function and enable improvement in swallowing disturbances and disease stress, emotional support and quality of care was enhanced. In addition to providing nursing care and encouraging patients with rehabilitation treatment programs, more in-depth understanding of the psychological needs of patients and their families by nursing practitioners should be applied, in order to give emotional support and expression tending toward enhanced and holistic quality nursing care.