照顧一位中年腦中風致失語症患者的護理經驗

The Nursing Experience of Caring for a Middle-Aged Patient with Aphasia Caused by a Stroke

中年期為順遂人生的顛峰時期，在此階段若發生腦中風且導致語言表達障礙，會使得原本順利的人生跟語言障礙一樣，變得讓人模糊未知。本文在敘述照顧一位中年男性因腦中風，造成表達性失語症的照護經過，護理期間為2008年12月10日至2008年12月31日，採實際護理、病歷查閱、溝通訪談及運用GORDON十一項健康功能評估，收集相關資料。過程中因個案的語言表達能力受損，而出現言詞溝通障礙、無力感及社交互動障礙問題，照護期間適時運用非語言性的溝通方式，以耐心傾聽與關懷的態度介入，協助個案渡過因腦中風導致表達障礙，而感受到的生命低潮。並於患病初期，建立治療性人際關係，與個案共同設定護理目標，幫助個案達成後，再給與正向的疾病觀念與鼓勵等做法，使個案對語言表達重拾信心，改善罹病後最在意的語言表達問題，協助個案做重返職場的準備，維持日後的生活品質。

Middle-age should be the peak period of life. A previously successful life will become uncertain and insecure if someone suffers a stroke leading to language barriers at that stage. This article describes the nursing experience of caring for a middle-aged male patient who suffered nonfluent aphasia caused by a stroke. The nursing period was from December 10 to 31, 2008. The methods of evaluation and information collection included direct care, review of the medical records, communication, interviews and GORDON 11 nursing assessment(s). The patient demonstrated impaired verbal communication, powerlessness, and impaired social interaction because his defective verbal expression. The nurse used the therapeutic relationship, non-verbal communication, patient listening, and a caring attitude to improve the patient's outlook and to overcome the depression caused by frustration in self-expression. Initially, it was helpful to establish a therapeutic relationship and then set nursing goals and assist the patient in achieving them. It is also important to restore a patient's confidence in his ability to express himself. If his frustration is overcome, he will be able to prepare to return to the workplace and maintain his l quality of life.