使用羅氏適應模式照護一位接受左心耳填塞術病人之護理經驗

Nursing Experience of a Patient Who Accepted the Left Atrial Appendage Occlusion Therapy Using the Roy Adaptation Model

10.6142/VGHN.202003_37(1).0011

林依昀(Yi-Yun Lin)；黃惠鈺(Hui-Yu Huang)

左心耳填塞術 ； 焦慮 ； 急性疼痛 ； left atrial appendage occlusion therapy ； anxiety ； acute pain

榮總護理

37卷1期（2020 / 03 / 01）

99 - 106

繁體中文

本文描述一位73歲男性因心房顫動使用口服抗凝血劑導致腸胃道出血後無法以傳統治療方式預防中風，改為接受左心耳填塞術之護理經驗。筆者於照護期間2016年11月7日至11月14日運用羅氏適應模式以病歷查閱、身體評估及會談等方式收集資料，並經由直接照護收集主客觀資料確立病人有急性疼痛及焦慮等兩項主要健康問題。藉由給予精油按摩、支托擺位、合宜的換藥技術等方式，再配合藥物治療緩解病人急性疼痛之問題；在照護過程中也運用傾聽、陪伴、主動關懷、提供音樂療法、芳香療法及耐心回答病人反覆性疑問等，降低焦慮程度。讓病人由術前至術後獲得連續性照護，並鼓勵及協助病人正視其所面臨到的衝擊，使其身、心、社會得到正向的適應。希冀藉此護理經驗分享，提供護理同仁日後照顧此類病人之參考。

In this paper, the care experience of a 73-year-old man with atrial fibrillation is described. The man was treated with oral anticoagulants to prevent stroke, but the traditional treatment triggered gastrointestinal bleeding. Therefore, he accepted the left atrial appendage occlusion therapy to avoid cerebral vascular accident. We reviewed the condition of the patient by applying the Roy adaption model through a review of medical records, physical assessment, and an interview during the nursing duration from November 7 to November 14, 2016. We collected subjective and objective data through direct care. The focus was on relieving the pain and anxiety of the patient. We performed a massage with essential oil, ensuring the patient was lying in a comfortable position, appropriate wound dressing, and medical care to ease acute pain. In terms of relieving anxiety, the author listened to the patient, provided company, and displayed active concern for the anxious patient. Moreover, we provided music therapy, aromatherapy, and answered repetitive questions of the patient to alleviate his anxiety during the caring period. We offered the patient continuous care from the preoperation to postoperation stages, supported his decision, and ensured physical, mental, and social adaption. Another key point was that aromatherapy considerably relaxed the patient. Therefore, we recommend placing essential oil in the ward. By sharing this experience, we hope to assist nursing staff and patients in similar situations.

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