一位脊髓損傷老年患者之護理經驗

A Nursing Experience of an Elderly Patient with Spinal Cord Injury

許斐媚(Fei-Mei Hsu)；許月華(Yue-Hua Shu)；柯薰貴(Hsun-Kuei Ko)

脊髓損傷 ； 跌倒 ； 焦慮 ； 護理經驗 ； anxiety ； falls ； nursing experience ； spinal cord injury

志為護理-慈濟護理雜誌

13卷2期（2014 / 04 / 01）

111 - 120

繁體中文

本文乃敘述一位脊髓損傷老年患者術後之護理經驗。個案因術後肢體麻木情況未如預期改善，因而引發身心困擾。護理期間為2011年11月4日至2011年11月13日，藉由身體檢查、觀察、會談等方式收集資料，確立的健康問題為知覺及感覺改變、焦慮及潛在危險性跌倒。針對健康問題提供適切與專業的護理活動，包括：教導個案認識及辨識環境可能的危險，以避免身體受到傷害；運用溝通技巧了解個案焦慮來源，使個案能抒發負向情緒感受並緩解焦慮；及協助個案持續進行漸進性主動運動，以強化肌肉力量預防跌倒發生。在此照護過程中，與個案建立良好的護病關係，透過人性關懷，成功地協助個案面對疾病所造成的身心衝擊，重新面對與適應其未來的生活。

This case report described the nursing experience of an elderly patient with spinal cord injury. The patient experienced physical and emotional distress when the numbness did not improve as expected after the surgery. The nursing period was from November 4, 2011 to November 13, 2011. The author collected data through physical examination, observation, interaction, conversation and listening, and the following nursing health problems were identified: altered sensorium and perception, anxiety and risk of fall. To address these issues, the following professional nursing interventions were implemented: teaching the patient to cognize and identify the dangers in the environment to avoid injuries; communicating with the patient to confirm the source of anxiety, which allowed the patient to express negative emotions and alleviate anxiety; assisting the patient to engage in progressive active exercise persistently to strengthen muscle power and avoid falls. During the nursing process, the author established a positive nurse-patient relationship and, through humanistic care, successfully aided the patient to face the physical and emotional impacts induced by the illness and to become adaptive to future life.