照護一位頭部創傷病人之護理經驗

A Nursing Experience of Caring for a Patient with Head Injury

2014年死傷之交通事故，造成415,048人傷亡，頭部創傷易導致毀容、失能、死亡，帶給病人及家屬諸多不適和不便，因而引發筆者探討動機，本文敘述一名45歲男性車禍頭部創傷之照護經驗，護理期間自2014年9月17日至9月22日，筆者運用整體性護理評估，以觀察、會談、傾聽、身體評估等技巧收集其生、心、靈、社會資料，確立個案有手術後疼痛及身體心像改變等健康問題，案妻因擔心個案手術預後，而有照顧者角色緊張的護理間題。照護期間筆者教導個案深呼吸技巧，並使用薰衣草精油及播放個案喜愛的音樂，緩解個案疼痛，同時發揮同理心給予鼓勵、支持，運用電子產品及網路，重建個案身體心像、回歸社會，提供案妻個案資訊及相關護理指導，並叮嚀案妻注意自身健康與教導放鬆技巧，改善案妻照顧者角色緊張的問題，協助個案及案妻面對此次突發意外事件的身、心衝擊，以回歸日常生活。臨床鮮少有放鬆療法的衛教單張或影片，建議臨床可多元製作放鬆療法衛教手冊及影片，提升病人及家屬的心理支持和照護品質，以達到身心平衡。

In 2014, there were an estimated 415,048 injuries or deaths secondary to traffic accidents. Disfigurement, disability and even death due to head injury result in patients' suffering and inconvenience in daily life activities, as well as family members' burden. This article describes a nursing experience of caring for a forty-five year-old male with head injury secondary to a motor vehicle accident. The nursing period was from September 17 to 22, 2014. With integral nursing assessment, the author collected the patient's information regarding psycho-social-spiritual needs through observation, interviews, listening, and physical examination. The nursing problems the patient encountered were postoperative pain and change in body image. The patient's wife, as a caregiver, was worried about the patient's progress after surgery and suffered from role tension. During the care period, the author taught the patient about deep breathing techniques, aromatherapy and playing soothing music for relaxation and relief of pain. With electronic products and website programs, the author encouraged and supported the patient with an emphasis on rebuilding the patient's body image before returning to society. The author offered the patient's wife head injury-relevant information and care guidelines of caregiver selfcare and relaxation skills, as well as assisting them in coping with the encountered impacts of the incident so that they could be able to return to daily life. Since few teaching materials or videos are available regarding proper relaxation technique, the author suggested producing more relevant handouts and videos to promote the patient and family's emotional support and ability to achieve body-mind balance.