運用失能概念照護一位初次腦中風個案之護理經驗

Utilizing the Concept of Disability in Nursing Care for a Patient with First-ever Stroke

10.6692/KJN.202005/SP_37.0011

林君儀(Chun-I Lin)；黃麗娟(Li-Chun Huang)；蕭華岑(Hua-Tsen Hsiao)

腦中風 ； 失能 ； 復健 ； 焦慮 ； stroke ； disability ； rehabilitation ； anxiety

高雄護理雜誌

37卷增訂刊（2020 / 05 / 01）

124 - 136

繁體中文

本文描述一位80歲初次罹患腦中風個案之護理經驗。於2017年10月30日至12月4日，藉由病歷查閱、身體評估、Gordon十一項功能性健康模式及失能概念作為評估指引，確立個案有身體活動功能障礙、自我照顧能力缺失、特定的知識缺失、焦慮等健康問題。照護期間個案由家屬陪同討論復健計畫，協助個案主動參與，以維持肢體活動功能，提升日常生活功能，在個別性措施照護與積極鼓勵下，依個案身體功能變化情形調整隔日復健計畫，使其達到部分自我照護能力。主動提供個案能理解的疾病照護及復健資訊，以減輕個案因疾病認知不足所產生的焦慮及心理衝擊。期望藉此護理經驗能提供護理同仁照護類似個案之參考，以提升對中風失能個案之照護品質。

This article describes the nursing experience of caring for an 80-year-old patient who suffered from a first-ever stroke. Patient's information of medical records, physical assessment was collected from October 30 to December 4, 2017. Gordon 11 Functional Health Patterns and disability concepts were used as assessment guidelines to identify four health problems, including impaired physical mobility; self-care deficits in feeding, bathing, dressing; deficient knowledge (specify); and anxiety. During the period of nursing care, we discussed the daily rehabilitation plan with the patient and his family, and assisted the patient to participate in rehabilitation actively to maintain functional physical activity and improve his daily life. Under the individual care plan and active encouragement, we adjusted the rehabilitation plan on the following days according to physical function performance of the patient, so that he could achieve partial ability of self-care. We proactively provided information on disease care and rehabilitation that could be understood in this individual case to decrease anxiety and psychological impact resulting from cognitive deficiencies of the disease. It is expected that this nursing experience will provide a reference for nursing colleagues to care for similar cases in improving the quality of care in stroke patients with disability.

1. 林君玲(Chun-Ling Lin);徐琬茵(Wan-Yin Hsu)(2023)。一位初次腦中風病人轉銜長照復能之護理經驗。志為護理-慈濟護理雜誌。22(6)。119-128。