照顧一位正顎手術後個案之護理經驗

Nursing Experience of Caring for a Patient with Orthognathic Surgery

10.6540/NTJN.202309_25(2).0013

許晴惠(Ching-Hui Hsu)；王惠萍(Hui-Ping Wang)；紀夙芬(Shu-Fen Chi)；葉淑玲(Shu-Ling Yeh)

正顎手術 ； 疼痛 ； 自我照顧 ； 舒適護理 ； orthognathic surgery ； pain ； self-care ； comfortable nursing

新臺北護理期刊

25卷2期（2023 / 09 / 01）

140 - 148

繁體中文;英文

文描述照護一位咬合不正接受正顎手術個案，術前因雙上肢曾燒燙傷，術後手指僵硬，以致學習自我照護時產生技能操作受限之護理經驗。護理期間自2020年3月1日至3月4日，筆者在臨床照護過程，運用身體評估、觀察、訪談及資料收集等方式，採Gordon十一項功能性健康型態評估表，進行整體性的護理評估，確立個案問題有：急性疼痛、潛在危險性感染及增進自我照顧能力的準備度等三項。照護期間利用藥物及非藥物來控制疼痛以及使用衛教單張、模型、一對一技能教導方式與教導雙手指關節運動和利用輔具，並以傾聽、陪伴和鼓勵表達心中感受協助個案，使其達到可獨立自我執行口腔清潔的目的和自我照顧能力。期望藉此護理經驗的分享，提供護理人員對日後照護此類型個案參考。

This article describes the post-orthognathic nursing experience of a patient with malocclusion who was limited in self-care skills and manipulation due to finger stiffness caused by burns on both upper extremities before the operation. The nursing period was from March 1st to March 4th, 2020. We conducted a holistic nursing assessment using data collected from physical assessments, clinical observations, interviews, and using Gordon's Functional Health Model tool to reveal health issues during the care of this case. Health concerns, in this case, included acute pain, potential risk of infection, and increased readiness for self-care. Medication and non-drugs were used to effectively manage pain during the nursing process. We also used health education leaflets, models, one-by-one skill teaching methods, and assistive devices to teach the movement of the finger joints. In addition, we helped this patient by listening, accompanying, and encouraging him to express his feelings. All of these measures aimed at achieving this patient's ability to perform oral hygiene and self-care independently. It is hoped that this nursing experience can provide a reference for the clinical nursing of similar patients in the future.

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