一位腦中風合併吞嚥困難病人之護理經驗

A Nursing Experience of a Patient with Dysphagia Caused by Stroke

10.6974/TCNJ.201108.0096

張家如(Chia-Ju Chang)；方宣雅(Hsuan-Ya Fang)；林雅慧(Ya-Hui Lin)；江東懋(Tung-mao Chiang)；王蓉敏(Rong-Min Wang)

吞嚥障礙 ； 腦中風 ； 吞嚥訓練 ； dysphagia ； stroke ； swallowing training

志為護理-慈濟護理雜誌

10卷4期（2011 / 08 / 01）

96 - 108

繁體中文

本文陳述一位76歲女性因腦中風造成吞嚥障礙、單側肢體無力等症狀，個案在住院期間，筆者運用觀察、會談、身體評估及Gordon十一項功能性健康評估等方式收集與分析資料，發現個案主要健康問題爲吞嚥功能障礙、身體活動功能障礙、潛在危險性損傷、身體心像紊亂等健康問題，依個案的個別性，與家屬的共同討論，並協同營養師、復健師、語言治療師等跨領域團隊的合作擬訂護理措施，使個案主動參與復健活動，協助個案調適因疾病所導致的活動障礙及吞嚥困難，引導配合復健治療增進日常生活功能，藉由成功之吞嚥訓練來滿足個案的基本需求，安全的由口進食，而免於合併症的發生。

This paper presented a nursing experience of a 76-year-old female who suffered from dysphagia and hemiparesis due to stroke. During her hospitalization, several measures were used for data collection and analysis, such as observation, conversation, physical evaluation and Gordon's 11 functional health patterns. Four issues were identified, including swallowing impairment, physical impairment, body image disturbance and potential risk of injury. After discussing with the family and assessing the patient's condition, a care plan was devised and implemented through the interdisciplinary cooperation with dietitian, physical therapist, occupational therapist, and speech language pathologist according to the patient's demand.. The care plan encouraged the patient to actively participate in rehabilitation programs, assisted the patient in dealing with conditions related to stroke-induced motor impairment and dysphagia, guiding her to cooperate with rehabilitation therapy to enhance activities of daily living, and satisfying the patient's basic demands, enable safe oral feeding, and prevention of pulmonary complications through successful swallow training.