照顧一位角膜潰瘍合併單眼視力損傷病患之護理經驗

An Experience Nursing of a Patient with Corneal Ulcer Combined with One-Eye Visual Impairment

10.30167/JOIT.200906.0026

洪嘉玲(Chia-Ling Hung)；陳志明(Chi-Ming Chan)；周繡玲(Hsiu-Ling Chou)

隱形眼鏡 ； 視力損傷 ； 急性疼痛 ； 感覺及知覺紊亂 ； 特定視覺 ； 焦慮 ； contact lens ； visual impairment ； acute pain ； disturbed sensory perception with specified visual perception ； anxiety

亞東學報

29期（2009 / 06 / 01）

231 - 241

繁體中文

因愛美及不喜歡戴眼鏡的緣故，隱形眼鏡成爲近視族群最普遍的選擇。然而享受隱形眼鏡所帶來的方便性，往往會忽略隱形眼鏡的保養措施，因而造成嚴重的角膜潰瘍現象。本文爲探討一位中年婦女因配戴隱形眼鏡造成左眼角膜潰瘍，單眼視力受損接近失明的狀態，讓個案面臨身心重大的衝擊。於2006年5月13至5月20日護理照顧期間，經由觀察、會談及直接照顧等方式進行相關資料之收集，並加以整理分析後，確立個案主要護理問題爲急性疼痛、感覺及知覺紊亂：特定視覺與焦慮。經由與個案建立良好的治療性關係，緩解角膜潰瘍造成的急性疼痛，再運用持續性關懷、傾聽及漸進式的護理活動，協助個案面對單眼視力損傷的事實，學習適應及接受視覺功能紊亂所帶來的影響，進而減輕視力損傷所導致的焦慮情緒，促使個案恢復正常的社交生活，同時鼓勵個案以正向的態度及勇氣來面對未來的生活。期望藉由此護理經驗能提醒眼科門診護理同仁在面對配戴隱形眼鏡的個案，應強調使用隱形眼鏡的注意事項，並重視隱形眼鏡對眼睛所帶來的嚴重影響。

For the sake of the beauty and the unfavorable feelings of wearing glasses, contact lens wearing becomes the most popular choice for people with nearsightness. Although contact lens wearing provides convenience, neglectness of proper use of contact lenses usually happens and it will cause severe corneal ulcer. In this case, we reported a middle-aged woman with left corneal ulcer caused by contact lens wearing, resulted in nearly blindness. This patient tackled serious physically and emotionally challenges. During the period of nursing care between 13 May, 2006 to 20 May, 2006, we collected data from careful observations and interviews as well as by using health assessment guide and analysis. The main problems of nursing care for this patient were identified as acute pain, disturbed sensory perception with specified visual perception and anxiety. Through building a good therapeutic relationship with the patient and continuing caring, listening and progressive nursing interventions, we assisted the patient to cope with the reality of the one eye vision impairment, learn to adapt and accept the effects from the visual disturbance, and further relieve the anxiety about losing vision acuity and promote normal socialization of the patient life. The patient was encouraged to face the future with courage and positive attitude. This nursing care experience is expected to be a reference for medical staffs in ophthalmology outpatient clinic to deal with the patients with contact lens wearing, to specify the proper use of contact lens and to inform the serious impact of contact lens wearing on eyes.

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