運用周全性老年評估於壓迫性骨折疼痛導致失能病人之護理經驗

Nursing Experience of Applying Comprehensive Geriatric Assessment to Patients With Disabilities Caused by Pain After Compression fracture

盧映瑄(Ying-Syuan Lu)；周美香(Mei-Hsiang Chou)；周明岳(Ming-Yueh Chou)；胡芳文(Fang-Wen Hu)

周全性老年評估 ； 壓迫性骨折 ； 疼痛 ； 失能 ； 無力感 ； comprehensive geriatric assessment ； compression fracture ； pain ； disabilities ； powerlessness

嘉基護理

24卷1期（2024 / 06 / 01）

68 - 80

繁體中文;英文

本文為描述一位80歲男性病人因跌倒導致壓迫性骨折，後續因疼痛臥床進而產生失能、壓傷及無力感之護理經驗。護理期間於2022年1月24日～2月15日，運用周全性老年評估，對個案身、心、靈與社會層面進行持續性評估，確立個案的主要健康問題：疼痛、自我照顧缺失、無力感。於護理過程中，運用藥物及非藥物治療，減緩疼痛；再透過復健治療，增加個案自我控制感，進而提升自我照顧能力。最後，經由關懷、同理心，鼓勵個案表達自我感受，協助正向面對失能造成的無力感。因高齡者健康問題具有複雜及交錯影響的特性，建議運用周全性老年評估於高齡者急性期照護，以多種標準化工具進行全方面評估，達到早期發現問題、介入並改善預後。同時，延伸考量高齡者返家後的長期照顧需求，於住院期間透過出院準備服務，連結長照資源，進而協助高齡者順利返家並提升生活品質。

This article describes a nursing experience of caring an 80-year-old male patient who suffered from a compression fracture due to fall, and was subsequently bedridden with pain, resulting in disability, pressure injury, and powerlessness. During January 24 to February 15, 2022, the comprehensive geriatric assessment (CGA) was applied to continuously assessment on the physical, psychological, spiritual and social of the patient. It determined the main health problems of the patient, including: pain, self-care deficit, and powerlessness. During the nursing process, pharmaceutical and non-pharmaceutical interventions were used to relieve pain. Moreover, the rehabilitation therapy was used to increase the sense of self-control in order to improve the ability of self-care. Finally, the patient was encouraged to express his feelings and it helped to face the powerlessness caused by disability. Due to the complex of health issues in elderly, it was recommended to employ CGA in the acute care of older adults. Using various standardized tools for a thorough assessment could lead to early detection of problems, interventions, and improved prognosis. Simultaneously, considered the long-term care needs of the elderly after returning home. Provided discharge planning services during hospitalization, connected with long-term care resources, assist the elderly in returning home smoothly, and enhanced their quality of life.