運用紐曼模式於年輕型腦中風患者之照護經驗

Nursing Experience of a Patient with Young Stroke Based on Neuman Model

10.6530/YYN/2015.4.03

洪玉玲(Yu-Ling Hung)；劉錦茹(Chin-Ju Liu)；侯雅萍(Ya-Ping Hou)；宋聖芬(Sheng-Fen Sung)

年輕型腦中風 ； 無效性因應能力 ； 紐曼模式 ； 糖尿病 ； 網路遊戲 ； young adult stroke ； ineffective coping ； Neuman's System Model ； diabeties ； online game

源遠護理

9卷2期（2015 / 06 / 01）

65 - 73

繁體中文

本文描述一位28歲個案罹患糖尿病8年，且近期失業後沉迷於網路遊戲，因慢性病及不健康生活模式引發年輕型腦中風致左側肢體無力之照護經驗。藉由觀察、會談、配合臨床理學及病歷查閱等收集資料，運用紐曼系統理論進行評估，確立健康問題有營養不均衡多於身體需要、身體活動功能障礙、無效性因應能力與照顧者角色緊張。藉由醫療團隊整體性照護，協助個案及照顧者共同擬定護理計畫，包括營養師運用營養評估提供減醣得舒飲食指導；透過多媒體光碟執行護理衛教及提供個別性復健計畫；藉腦中風病友團體正向支持面對接受腦中風後肢體障礙，醫療團隊提供照顧者照護技巧、回覆示教及社會福利資訊，以減少個案因應壓力，重拾自信心回歸職場工作。

This article describes the nursing care experience of a 28-year-old patient diagnosed with diabetes 8 years ago who experienced young adult stroke and left limb weakness. The patient was unemployed and addicted to an unhealthy lifestyle of playing online games. Patient data was collected through interviews, active listening and a medical record review. Neuman's System Model identified the care problems: (1) imbalanced nutrition: more than body requirements, (2) dysfunction of physical activity, (3) ineffective coping, and (4) caregiver role strain. The multidisciplinary team approach to the patient and his family included DASH diet guidance and nutrition evaluation, individualized rehabilitation programs for young stroke patients, health education, stroke friendship support groups to help his acceptance of physical disabilities, teaching of self-care skills, and information on social welfare resources. Effective coping may reduce his stress and regain his confidence to reenter the workforce.

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