一位燒傷患者急性疼痛之照顧經驗

A Nursing Experience of a Burn Patient With Acute Pain

林雅娟(Ya-Chuan Lin)；張峰玉(Fung-Yu Chung)

燒傷 ； 急性疼痛 ； acute pain ； burns

志為護理-慈濟護理雜誌

17卷3期（2018 / 06 / 01）

112 - 122

繁體中文

本文為一位燒傷患者因長期面臨反覆急性疼痛壓力，產生害怕、恐懼、失眠，甚至焦慮情緒之照顧經驗。筆者於2014年2月24日到2014年3月19日照護期間，藉由觀察、會談、身體評估及持續性照護收集資料，並運用羅氏適應模式評估主要及重要健康問題：急性疼痛、組織完整性受損和焦慮；運用藥物及非藥物疼痛控制，讓患者配合換藥過程並使疼痛獲得緩解；提供個別性換藥流程、傷口照護與營養攝取，促使傷口癒合；透過語言和非語言，了解內心害怕及不安感受，使其渡過疾病治療過程，勇於面對身、心及社會問題。建議可運用手機通訊軟體與親朋好友建立支持網絡，手機遊戲轉移疼痛感受，以及完善照護模式，提供完整療護。

The article described a nursing experience of a burn patient who suffered from fear, insomnia, and anxiety induced by the stress from chronic acute pain. The nursing period lasted from February 24^(th) to March 19^(th), 2014. With Roy's adaptation model as assessment framework, data were collected via observation, interview, physical assessment, and continuing care. The primary health issues were acute pain, impaired tissue integrity, and anxiety. To address these issues, the following interventions were implemented: achieve pain relief and the patient's cooperation during dressing through drug and non-drug pain management; facilitate wound healing through individualized dressing procedure, wound care, and nutritional intake; facilitate the expression of the patient's inner fear and uncertainty through verbal and non-verbal communication, allowing him to endure the treatment process and confront the physical, psychological, and social issues. It is recommended to build a social support network using mobile communication apps, distract pain with mobile games, and provide holist care via holistic care model.

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