運用組合式照護於一位初次腦中風肥胖婦女之護理經驗

A Nursing Experience of Applying Care Bundle in Managing for a First Time Stroke Patient with Obesity

本文是描述運用組合式照護於ㄧ位初次腦中風肥胖婦女之護理經驗。護理期間自2020年6月17日至7月25日，採用Gordon十一項功能性健康型態評估，運用觀察、會談及理學檢查收集資料，確立「肥胖」、「身體活動功能障礙」與「無力感」之護理問題。筆者運用組合式照護增進減重成效，包括採用地中海飲食、設計運動計畫及根據現有的科學實證使用耳穴按壓。另外，鼓勵個案主動與健康照顧專業人員討論復健進展、強化復健的動力及確實執行復健訓練，以改善肢體的肌肉力量。進一步地，應用正念與轉念，學習與中風後遺症共存，改善其無力感。期此護理經驗可提供護理同仁未來在照顧類似病人之參考。

This article described the nursing experience of applying care bundle in managing for a first time stroke patient with obesity. The nursing period was from June 17 to July 25, 2020. Gordon's 11 functional health patterns were conducted collecting data through observation, interview, and physical examination. The identified nursing problems included obesity, impaired physical mobility, and powerlessness. The author applied care bundle to enhance the effectiveness of weight reduction, including adopting a Mediterranean diet, designing an exercise program, and employing auricular acupressure based on available scientific evidence. Additionally, this individual was encouraged to proactively discuss the rehabilitation progression with healthcare professional, increasing the motivation for rehabilitation, and actually performing rehabilitation training to improve the muscle strength of the limbs. Further, using mindfulness and changing mindset to learn living with stroke sequelae and to improve powerlessness. We hope that this nursing experience will serve as a reference for nursing professional in caring for similar patients in the future.