一位脊髓損傷青年面臨身心衝擊之護理經驗

A Nursing Experience of Young Man with Spinal Cord Injury Facing Physical and Psychological Impact

本文描述一位20歲排球校隊青年，因脊髓損傷臥在病榻由家人照護而產生無望感，引發同為年輕熱愛運動的作者探討之動機，故於2022年2月25日至3月18日照顧期間，以觀察、身體評估及互動會談等方式，運用羅氏適應模式進行護理評估，確認個案有呼吸道清除功能失效、身體活動功能障礙、無力感及家庭因應能力增進的準備度之健康問題。藉由跨團隊合作，共同擬定整合復健照護及呼吸訓練計畫，使其成功移除氣切管路，在復健過程結合排球增加動機，然面對疾病造成的心理影響，依照脊髓損傷五個心理適應期提供相呼應措施，得以正向態度面對漫長的復健之路，再者引導家中成員重整角色職責互相扶持渡過難關。此外，家屬面臨長期的照護問題，團隊以無縫接軌的方式銜接社福資源，使返家可持續獲得有品質的照護，同時也減輕案父母的負擔；但銜接個案出院準備服務時，發現南部脊髓損傷的社福資源零散且無規劃，建議社福單位可以促進北中南學術交流，提供脊髓損傷病人獲得更多資源，及醫療院所可設立脊髓損傷個管師，主動提供出院後定期追蹤及訪視，使病人獲得整體性照護。期許此經驗能提供日後脊隨損傷個案照護之參考。

This article describes a 20-year-old volleyball team youth who felt hopeless because of a spinal cord injury lying on the sickbed and being taken care of by his family, which inspired the motivation of the young sports-loving author. The nursing period was from February 25 to March 18, 2022,Nursing assessment through observation, physical assessment, interactive interviews and the use of the Roche adaptation model, the main nursing problems were airway clearance failure, physical activity dysfunction, powerlessness, and family coping ability.
Through Interprofessional Care, jointly develop a rehabilitation and respiratory training plan to successfully remove the tracheostomy circuit, and incorporate volleyball into the rehabilitation process to increase motivation, However, in the face of the psychological impact of the disease, we provide assistance according to the five stages of spinal cord injury, so that we can face the long road to recovery with a positive attitude, and then guide family members to reorganize their roles and responsibilities and support each other to overcome difficulties.
In addition, when family members face long-term care problems, the team quickly connects social welfare resources, so that patients can continue to receive high-quality care when they return home, and at the same time reduce the burden on parents; when connecting patients with discharge preparation services, they found that the social welfare resources for spinal cord injury in the South were scattered and unplanned. It is suggested that social welfare units can promote multi-party academic exchanges and provide spinal cord injury patients with more resources. visits to enable patients to receive holistic care and medical institutions can set up personal spinal cord injury managers to actively provide regular follow-up and visits after discharge, so that patients can receive holistic care. We hope that this nursing experience can serve as a future reference for nursing staff with similar cases.