一位初次癲癇發作個案之急診護理經驗

An Emergency Nursing Experience of a Patient with a First Epileptic Seizure

趙子慧(Zi-Huei Chao)；吳貞鋆(Chen-Yun Wu)；郭嘉琪(Chia-Chi Kuo)

初次癲癇發作 ； 潛在危險性創傷 ； 否認行為不當 ； 無效性自我健康管理 ； first epileptic seizure ； risk for trauma ； ineffective denial ； ineffective self-health management

志為護理-慈濟護理雜誌

14卷5期（2015 / 10 / 01）

127 - 136

繁體中文

本文是筆者於急診照護初次癲癇發作的個案，急診照護期間為2012年8月24日13:20至8月24日16:30，藉由Gordon十一項健康功能型態為評估架構，運用身體評估、觀察、會談、傾聽及溝通等方式收集資料，確立個案主要之健康問題依序為潛在危險性創傷、否認行為不當、無效性自我健康管理。照護初期個案拒絕面對癲癇發作的事實，拒絕接受治療與護理，筆者藉由反覆溝通與觀察後，發現個案拒絕的理由在於否認自己罹患癲癇疾病與其錯誤的認知，筆者藉由陪伴與護理指導讓個案瞭解適當的治療是可以有效控制並預防癲癇再次發作，後續電訪個案定期返回神經內科門診追蹤，目前暫無續發作之紀錄，顯示個案了解癲癇自我管理之重要性。期望藉此分享初次癲癇發作之急診護理經驗，提供急診照護之參考。

This paper described the emergency nursing experience of a patient with a first epileptic seizure. During the nursing period from 13:20 to 16:30 on August 24, 2012, we used Gordon's 11 functional health patterns as the assessment framework and collected data through physical assessment, observations, conversations, listening, and communication. The health problems included risk for trauma, ineffective denial, and ineffective self-health management. To deal with the patient's refusal to accept the diagnosis of epilepsy and related treatment and care, we engaged in ongoing communication and observations in the beginning of the nursing process, and identified that the reason for the patient's refusal was the denial and misconceptions of epilepsy. In response, we provided companionship and health education to help the patient to understand that epileptic seizures could be effectively controlled and prevented through appropriate treatment. Follow-up telephone interviews revealed that the patient had returned to the neurology clinic on regular basis and showed no recurrence of epilepsy, which displayed an thorough understanding of the importance of epilepsy self-management. We would like to share this experience with clinical nurses as a reference when providing emergency nursing care for patients with a first epileptic seizure.

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