運用賦權概念照護一位食道閉鎖合併食道氣管瘻管早產兒之護理經驗

Nursing Experience of Applying the Creating Opportunities for Parent Empowerment Model for a Premature Infant With Esophageal Atresia and Tracheoesophageal Fistula

10.6142/VGHN.202306_40(2).0007

羅珮瑜(Pei-Yu Lo)；王琪(Chi Wang)；彭雪芳(Hsueh-Fang Peng)

創造父母賦權模式 ； 食道閉鎖合併食道氣管瘻管 ； 早產兒 ； creating opportunities for parent empowerment ； esophageal atresia and tracheoesophageal fistula ； premature

榮總護理

40卷2期（2023 / 06 / 01）

166 - 172

繁體中文;英文

本文為運用賦權概念照護一位食道閉鎖合併食道氣管瘻管早產兒之護理經驗，筆者於2021年1月9日至2月24日護理期間，藉由觀察、身體評估及會談收集資料，以Neuman系統理論執行護理評估，確立病嬰有潛在危險性肺吸入、潛在危險性依附關係障礙及親職角色衝突等健康問題。筆者首以COPE模式做為指引，及早提供介入性措施，引導父母每日學習和參與病嬰的照護，增強父母信心及控制感，協助親子關係的建立；再輔以提供病嬰生長發育及疾病相關資訊的書面或網路護理指導，協同跨領域專家的團隊合作，及早啟動出院準備，終能達到病嬰出院前父母具備早產兒居家照護能力及食道閉鎖合併症症狀的辨識與處理，藉由賦權概念的運用，提升病嬰返家後照護品質，期盼透過此次照護經驗分享，作為臨床護理人員日後照護之參考。

This case report describes the nursing experience of the author in applying the Creating Opportunities for Parent Empowerment (COPE) model to the care of a premature infant with esophageal atresia and tracheoesophageal fistula. The Newman Systems Model was employed for nursery assessment between January 9 and February 24, 2021. Data was collected through observation, conversation, listening and physical assessments during the caring period. The patient's primary health concerns pertained to aspiration risk, nutritional deficiency, attachment impairment, and parental role conflicts. During the nursing period, nursing guidance on the performance of daily care tasks was provided through written and online media using the COPE model to parents, thus helping them care for the patient more effectively and cultivate a positive parent-child relationship. Additionally, multidisciplinary professionals were invited to assist in the patient's therapy and recovery, particularly in identifying and treating the complications of esophageal atresia, for the patient to be discharged in a timely manner. Through parent empowerment, the quality of family care was improved. This nursing experience may serve as a reference for clinical nurses and families managing high-risk neonates with esophageal atresia.

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