一位老年退化性關節炎患者術後之護理經驗

The Nursing Care Experience of an Elderly Patient with Knee Osteoarthritis and Left Total Knee Replacement

10.6692/KJN.201812_35(3).0011

簡羚芸(Lin-Yun Jian):黃麗娟(Li-Chun Huang)；歐羽珊(Yu-Shan Ou)

退化性關節炎 ； 老年 ； 術後復健 ； Osteoarthritis ； elderly ； rehabilitation nursing

高雄護理雜誌

35卷3期（2018 / 12 / 01）

118 - 129

繁體中文

退化性膝關節炎是導致老年人失能的原因之一，嚴重的關節病變，通常須接受手術，以改善關節活動問題。本文敘述一位患有退化性膝關節炎之老年病人，行左膝關節置換術之護理經驗，護理期間自2016年2月15日至2月20日，透過直接護理、身體評估、觀察、以及病歷查閱等方式收集資料，運用Gordon十一項功能性健康型態進行整體性評估，確認有疼痛、身體活動功能障礙與焦慮等問題。針對問題提供護理措施，包括建立良好護病關係，協助疼痛控制、緩解焦慮及身體不適與協助術後復健，藉以改善患肢關節活動，提升生活品質。期望藉此護理經驗，提供日後臨床此類個案照護之參考。

Knee osteoarthritis is a progressively degenerative disease, and is a leading cause of disability with incidence and prevalence rising in most elderly populations. Patients with severe knee osteoarthritis need to be treated by total knee replacement, to improve joint activity and quality of life. The aim of this case report was to illustrate the experience of nursing care for an elderly female patient undergoing total knee replacement between 15th to 20th February in 2016. The data was collected by direct care, physical assessment, observation, listening, communication, and medical record review. The authors evaluated her health problems by Gordon's 11-item functional health pattern and found her problems were combined with acute pain, impaired physical mobility and anxiety. According to these, we rendered measures that included construction of a significantly strong nurse-patient relationship to control pain, lessen her anxiety and discomforts, and provide rehabilitation activities to enhance her joint's flexibility and quality of lift. We hope that our experience can provide nursing staff with a reference to care for patients receiving total knee replacement.