一位腦動靜脈畸形併腦出血青少女術後恢復期之護理經驗

Nursing Experience of a Teenage Girl with Cerebral Arteriovenous Malformation and Cerebral Hemorrhage During Recovery Period

本文探討一位16歲青少女在無預警的情況下發生左側小腦動靜脈畸形破裂合併小腦出血，在術後恢復期對自我身心及照護上感焦慮、無助之護理經驗。筆者於2022年2月18日至2月26日以直接照護、觀察、身體評估、查閱病歷及會談等技巧進行資料收集，採Gordon十一項健康功能型態作為評估指引，確立護理問題包括：身體活動功能障礙、焦慮及照顧者角色緊張。護理過程提供復健方案設計、重複性肌力訓練及個別性護理措施，提升自我照顧能力，同時利用關懷、傾聽及鼓勵，使個案在治療過程增加自信、提升自我認同緩解焦慮，並與照顧者討論適合的減壓方式，緩解照顧過程的緊張及壓力。建議院方可以製作復健社群軟體，讓病人出院後可以於軟體上記錄復健狀況，任何問題可線上詢問復健老師，院方也可以立即獲得病人資訊及復健狀況，確保適應生活型態、重返校園，達到完整性照護。希望藉此經驗分享提供護理人員照護類似病人之參考。

This article described a nursing experience of a 16-year-old girl in the recovery period after surgery for arteriovenous malformation and cerebral hemorrhage. From February 18 to February 26, 2022, the author collected data on Gordon’s 11-item Functional Health Assessment through direct care, observation, physical assessment, medical records and interviews, established nursing problems include: physical activity dysfunction, anxiety and caregiver role tension. The nursing process provides rehabilitation plan design, repetitive muscle strength training and individual nursing measures to improve self-care ability. At the same time, care, listening and encouragement are used to increase the self-confidence of the case during the treatment process, enhance selfidentity, relieve anxiety, and communicate with caregivers. Discuss appropriate ways to reduce stress and ease the tension and stress of the caregiving process. It is suggested that the hospital can create rehabilitation social software, so that patients can record the rehabilitation status on the software after discharge. Any questions can be asked online by the rehabilitation teacher. The hospital can also immediately obtain the patient's information and rehabilitation status to ensure that they can adapt to their lifestyle, return to school, to achieve complete care. We hope to use this experience sharing as a reference for nursing staff to care for similar patients.