一位年輕女性接受全髖關節置換術之護理經驗

Nursing Experience of a Young Woman Undergoing Total Hip Replacement

10.29494/LN.202109_22(3).0008

陳錚(Cheng Chen)

發展性髖關節發育不全 ； 性生活型態改變 ； 年輕女性 ； developmental hip dysplasia ； change of sexual life pattern ； young woman

領導護理

22卷3期（2021 / 09 / 01）

101 - 116

繁體中文

本篇描述一位發展性髖關節發育不全的女性，接受全髖關節置換術後對於預後及性生活型態產生極大壓力的護理經驗。護理期間自2018年03月11日至2018年03月15日，運用觀察、會談與病人溝通互動、傾聽、收集主、客觀資料，筆者以Gordon十一項功能性健康模式做整體性評估，確立個案有急性疼痛、身體活動功能障礙、焦慮、對性生活型態知識缺失及身體心像紊亂等健康問題。護理過程中除了提供止痛藥與自控式止痛法，並教導深呼吸方式、聽喜愛音樂與影片及使用芳香療法緩解術後疼痛；會同復健科協助教導示範輔具的正確使用及行走的注意事項；藉由傾聽技巧，讓個案表達心理的感受，鼓勵與病友分享手術經驗緩解焦慮；鼓勵男朋友與個案一起參與計畫、提供髖關節術後性姿勢的圖文解說，協助個案與男朋友性生活型態改變的調適。護理人員除了提供對於髖關節手術之身、心照護問題外，對於性生活的議題亦應重視，建議在職教育加強相關的性諮商課程，讓護理人員接觸病患此健康問題時，亦能提供相關諮詢與照護。期望藉此護理經驗分享，提供類似個案在照顧上之參考，以提升照護品質。

This article describes the nursing experience of a woman with developmental hip hypoplasia who had to undergone a total hip replacement surgery that puts great pressure on the prognosis and sexual life style. During nursing period, from March 11th to 15th, 2018, using observations, conversation to communicate with the patient; listening for subjective and objective data collection. The author uses Gordon's Eleven Functional Health Models to make a holistic assessment, and the case was diagnosed to have several nursing issues including acute pain, physical dysfunction, anxiety, lack of knowledge about sexual life patterns, and disturbance of body and mental images. In addition to supply painkillers and self-controlled pain relief during the nursing process, also coach deep breathing methods, listening to favorite music and videos as well as using aromatherapy to relieve postoperative pain. In conjunction with the Rehabilitation Department, assist in teaching and demonstrating the proper usage of assistive devices and precautions when walking. Encourage the boyfriend to participate in the project with the patient, provide graphic explanations of the postoperative sexual posture of the hip joint, and assist the client to adjust sexual life patterns with the boyfriend. In addition to provide physical and mental care for hip surgery, nursing staff should also pay attention to issues in regards to sexual life. It is recommended that on-the-job education to reinforce in the relevant sexual consultation courses so that nursing staff can also provide relevant advice and care when dealing with this type of health issues. It is hoped that by sharing this care experience will provide a reference to similar cases in order to improve the quality of care.

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