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題名:一位手部截肢患者之創傷後反應和調適過程之探討
書刊名:長庚護理
作者:楊淑玲凌美貝
作者(外文):Yang, Su-lingLing, Mei-pei
出版日期:2003
卷期:14:2=42
頁次:頁166-175
主題關鍵詞:手部外傷創傷後反應截肢Hand traumaPost-traumatic responseAmputation
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(4) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:4
  • 共同引用共同引用:43
  • 點閱點閱:93
     勞工在遭遇到職業性創傷後,大都會發生心理、生理、經濟與社會等等之障礙。本文以探討一位中年男性勞工在遭遇到右手職業外傷後,經多次治療及手術後,仍需面臨截肢的護理經驗,期望能提供臨床專業人員參考,以促進臨床護理品質之提昇。本文以個案研究,立於主護護士的角度,將護理個案期間,撰寫成12篇行為過程實錄,導入「創傷後反應」之概念,分析整理歸類個案於創傷後之反應,發現個案出現了「事件衝擊性表徵」、「情緒性表徵」、「功能改變性表徵」共13項定義特徵及身體心像的改變。個案本身所採取之調適行為有「問題取向調適策略」及「情緒取向調適策略」內容包括焦慮、否認、害怕、逃避、宿命論等。筆者對個案提出的護理措施包括建立信任關係、協助尋求醫療上資源、提供靈性支持、學習替代技巧、介紹成功個案等等,成功地協助個案面對與突破其生理與社會之障礙。本文實為個案護理實例,筆者運用創傷後反應之護理照護概念、技巧與護理措施,陪伴個案成功地面對(coped with)與處理其失去的右手手指,不僅提供個案所需的整體性照護,亦減低因非計畫性截肢對個案之身、心、家庭、社會及經濟的衝擊協助其適應,重新面對生活。
     Patients with traumatic hand injuries often encounter various physiological, psychological, emotional, and economical and social stresses after the accident. This article shared the nursing experience towards a middle age man who underwent a series of treatment along with several surgical procedures after an occupation hand injury, yet still faced the fate of right hand fingers amputation. During the nursing care, data were collected as 12-process recording. The results were analyzed based on the identified characteristics of post traumatic responses. The results showed that the patient had 13 characteristics of post traumatic responses presenting in the event impact manifestations, emotional manifestations, functional change manifestations, and body image distrbance. The coping behaviors included problem-oriented coping behaviors and emotion-oriented coping behaviors, including anxiety, denial, fear, escape, and fatalism. Nursing interventions included establishment of mutual trust relationship, assistance in looking for medical resources, support in spirituality, and learning of alternative skills. This case report could serve as a reference for caring amputation patient.
期刊論文
1.Bomar, K. S.、Calandruccio, J. H.(1996)。Crush injuries to the hand and forearm。Orthopaedic Nursing,15(6),56-65。  new window
2.郭梅珍、高紀惠(19960300)。車禍外傷患者創傷後反應的定義特徵之臨床效度測定。長庚護理,7(1)=13,12-25。new window  延伸查詢new window
3.柯薰貴、鍾信心、許淑蓮、張永源(20020300)。乳房腫瘤婦女術前不確定感、調適策略及其相關性之探討。長庚護理,13(1)=37,32-42。new window  延伸查詢new window
4.陳莉莉、林麗嬋(19971000)。手部職業創傷患者的衝擊及護理。護理雜誌,44(5),83-88。new window  延伸查詢new window
5.陳淑卿、賴裕和、林佳靜、陳宏基(19991200)。手部外傷病患住院期間之急性創傷後反應--量表發展及現況。長庚護理,10(4)=28,31-39。new window  延伸查詢new window
6.Grunert, B. K.、Matloub, H. S.、Sanger, J. R.、Yousif, N. J.(1990)。Treatment of posttraumatic stress disorder after work-related hand trauma。The Journal of Hand Surgery,15(3),511-514。  new window
7.Hsiao, H. T.、Yu, C. M.(1999)。A clinical analysis of hospitalized occupational hand injuries。J. P. R. S. A. R. O. C.,18(4),253-260。  new window
8.Michaels, A. J.、Michaels, C. E.、Moon, C. H.、Smith, J. S.、Zimmerman, A.、Taheri, P. A.、Peterson, C.(1999)。Posttraumatic stress disorder after injury: impact on general health outcome and early risk assessment。The Journal of Trauma Injury Infection and Critical Care,47(3),460-465。  new window
9.Yetzer, E. A.(1996)。Helping the patient through the experience of an amputation。Orthopaedic Nursing,15(6),45-50。  new window
10.許玉雲、陳彰惠(19991200)。身體心像概念分析。護理雜誌,46(6),103-109。new window  延伸查詢new window
11.孫美華、劉雪娥(20001000)。「身體心像紊亂」之概念分析。護理雜誌,47(5),77-82。new window  延伸查詢new window
12.Gustafsson, M.、Amilon, A.、Persson, L. O.(2000)。A qualitative study of stress factors in the early stage of acute traumatic hand injury。Journal of Advanced Nursing,32(6),1333-1340。  new window
圖書
1.周幸生、歐嘉美、蘇雅玲、蔡素華、康百淑、葉明珍(1998)。新臨床護理診斷。台北:華杏。  延伸查詢new window
2.胡月娟(1997)。現代內外科護理。台北:華杏。  延伸查詢new window
圖書論文
1.胡月娟(1998)。肌肉骨骼外傷的處理。現代內外科護理。台北:華杏。  延伸查詢new window
2.Aguilera, D. C.(1998)。Post traumatic stress disorder and acute stress disorder。Crisis intervention theory and methodology。Mosby。  new window
3.Morrison, J.(1995)。Posttraumatic stress disorder。DSM-IV made easy the clinician's guide to diagnosis。New York:Guilford Press。  new window
 
 
 
 
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