一位年輕男性接受腰椎融合術之手術全期護理經驗

Perioperative Nursing Experience of a Young Man Undergoing Lumbar Fusion Surgery

江芷嫻(Chih-Hsien Chiang)；李旻燕(Min-Yen Lee)

腰椎融合術 ； 個別性的護理 ； 醫療團隊合作 ； 手術全期護理 ； Lumbar Fusion ； Individual Nursing ； Medical Team Cooperation ； Perioperative Nursing

若瑟醫護雜誌

16卷1期（2022 / 03 / 01）

116 - 127

繁體中文

協助一位患有退化性腰椎狹窄及椎間盤突出的年輕男性，對疾病的疼痛與活動功能受限常感到困擾，面對經濟負擔及害怕手術後造成半身癱瘓，而拒絕手術選擇症狀療法，運用手術全期護理照護模式，提升個案對手術治療的信心及日後生活品質。自2019年4月23日至4月28日護理期間，運用Gordon 11項健康功能評估確認有：焦慮、潛在危險性手術情境傷害、急性疼痛及身體功能障礙之健康問題。於術前提供疾病手術相關資訊，與醫療團隊討論健保費用之申請，藉由分享和傾聽等技巧解決焦慮；術中維護安全與隱私以專業知識及技能，預防潛在危險性傷害；術後傷口疼痛教導非藥物局部按摩及溫度柔和技巧等緩解疼痛，照會社服協助申請免費輔具使用暨物理治療師提供獨特性之復健運動，以增進自我照顧能力。術前焦慮的緩和能勇敢接受手術；術中依個別性照護無潛在危險性手術情境傷害；術後運用非藥物技巧緩解傷口疼痛，於出院後電訪追蹤表示能獨立完成自我照顧。由專業照護團隊提供整合資源，給予全方位照護以落實手術全期護理，進而改善生活品質早日回歸生活軌道。

To assist a young man with degenerative lumbar spine stenosis and intervertebral disc herniation. He is often troubled by the pain and limited mobility of the disease. Facing the financial burden and fear of paralysis after surgery, he refuses to choose the symptoms of surgery. Therapy, using the full-period nursing care model of the operation to enhance the confidence of the case in surgical treatment and the quality of life in the future. During the nursing period from April 23 to April 28, 2019, using Gordon's 11 health function assessments found that: anxiety, potentially dangerous surgical situational injuries, acute pain and physical dysfunction health problems. Provide information about the disease and surgery before surgery, discuss the application of health insurance fees with the medical team, resolve anxiety by sharing and listening skills; maintain safety and privacy during the surgery and prevent potentially dangerous injuries with professional knowledge and skills; postoperative wound pain teaching Non-medicinal local massage and temperature softening techniques to relieve pain, according to the social service to assist in applying for free assistive devices and physiotherapists to provide unique rehabilitation exercises to enhance self-care ability. The anxiety relieved before surgery can bravely accept the operation; during the operation, there is no potential dangerous surgical situation injury according to individual care; after the operation, non-drug techniques are used to relieve the pain of the wound, and the follow-up call after discharge indicates that they can independently complete self-care. The professional care team will provide integrated resources and provide comprehensive care to implement the full-period care of the operation, so as to improve the quality of life and return to the life track as soon as possible.

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