照顧一位肌萎縮側索硬化症病患之護理經驗

The Nursing Experience of a Patient with Amyotrophic Lateral Sclerosis

10.6692/KJN-2011-28-1-8

蔡佳華(Chia-Hua Tsai)；林碧莉(Pi-Li Lin)；江秀珠(Hsiu-Chu Chiang)

肌萎縮側索硬化症 ； 無望感 ； 護理經驗 ； 物理治療 ； Amyotrophic lateral sclerosis ； Hopelessness ； Nursing ； Physical therapy

高雄護理雜誌

28卷1期（2011 / 04 / 01）

83 - 93

繁體中文

本文為協助一位罹患肌萎縮側索硬化症患者，因疾病初期不知如何於肢體功能未完全喪失前，做適當的復健治療維持身體現況，進而產生無望感的中年婦女，藉由建立溝通管道、復健護理與重建自信心的護理經驗。護理期間為2007年7月24至2007年8月10日，以Gordon十一項健康功能型態進行評估，發現個案有無望感、身體活動功能障礙、自我照顧能力缺失、吞嚥障礙、言辭溝通障礙、潛在危險性傷害等健康問題。經由筆者以主動關懷，給予正向強化機制而增加控制感及因應能力；運用輔具、環境塑造，促進自我照顧；提供圖卡、字卡，以助於表達；教導家屬跌倒預防方法及重要性、了解疾病並提升照顧能力進而改善生活品質，期望以此照護經驗提供同仁參考。

This article describes the nursing experience of a patient with Amyotrophic Lateral Sclerosis (ALS). The patient considered herself to be in a state of hopelessness, because she did not know how to maintain a current healthy status of the body with appropriate rehabilitation in the initial stage of disease. To establish a method of communication and nursing rehabilitation, the patient achieved the reestablishment of her self-confidence. The nursing care lasted between July 24th and August 10th, 2007. In the study of the nursing process, the author uses Gordon's functional assessment tools to establish the health problems, including a sense of hopelessness、impaired physical mobility、self-care deficit、dysphagia、language barriers to communication, and the potential risk of injury problems. The main nursing interventions included encouraging positive thinking, caring and physical activities, the use of communication devices and safety environment, patient-promoted self-care ability, and by providing picture and word cards, the patient expressed herself to the mental situation. This case report might serve as a reference in guiding nurses to provide appropriate nursing interventions in helping clients with similar problems to enable self-care ability and improve their quality of life.