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題名:一位不完全脊髓損傷病人之急診照護經驗
書刊名:長庚護理
作者:蔡維倫郭嘉琪
作者(外文):Tsai, Wei-lumKuo, Chia-chi
出版日期:2017
卷期:28:2=98
頁次:頁303-313
主題關鍵詞:脊髓損傷急性疼痛身體活動功能障礙焦慮Spinal cord injuryAcute painPhysical activity dysfunctionAnxiety
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(0) 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:0
  • 共同引用共同引用:11
  • 點閱點閱:8
本文旨在探討一位60歲女性因外傷導致腰椎骨折合併不完全脊髓損傷的急診護理經驗。護理期間自2014年6月19日10:30至16:44,運用Gordon十一項健康功能型態為評估架構,藉由身體評估、觀察、會談、病歷查閱等方式資料收集,確立急診期間的健康問題為急性疼痛、身體活動功能障礙及焦慮。個案因高處跌落意外造成嚴重脊髓損傷,致肢體疼痛、活動功能障礙及對手術與預後的焦慮,因而在急診發洩負向情緒影響急性期照護與手術決策。急診團隊運用放鬆技巧、圓滾木翻身與舒適擺位,來減輕疼痛與預防身體活動功能障礙的續發性傷害,運用傾聽、關懷及口頭鼓勵方式,引導個案說出焦慮感受,再透過問題釐清與心理支持,讓個案有信心接受手術與面對未來挑戰,幫助提升治療配合度與早期治療成效。
This paper describes the emergency nursing experience of caring for a 60-year-old female patient with traumatic lumber fracture combined with incomplete spinal cord injury. The nursing period was from 10:30 to 16:44 on June 19, 2014. We used Gordon's 11 functional health patterns as the assessment framework and collected data through physical assessment, conversations, and chart review. The health problems included acute pain, physical activity dysfunction, and anxiety. Due to severe spinal cord injury caused by an accidental fall from height, this patient experienced extremity pain, physical activity dysfunction, and anxiety toward surgery and prognosis. The patient vented negative emotions at the emergency department, which adversely affected the emergency nursing care and surgical decision-making. During the nursing process, the emergency team conducted strategies such as relaxation techniques, logrolling, and positioning to alleviate the patient's pain and prevent secondary injury from physical activity dysfunction. In addition, we applied listening, caring, and verbal encouragement to guide the patient to express anxiety. We also provided problem clarification and mental support to convince the patient to undergo surgery and face future challenges, and improve the treatment adherence and outcomes of early intervention.
期刊論文
1.鄭玉華、盧美秀(20070600)。手術前疼痛衛教對改善脊椎術後病人疼痛經驗之成效探討。實證護理,3(2),107-118。new window  延伸查詢new window
2.林祐如、賴美玉(20120800)。照護一位因脊髓損傷引發疼痛與焦慮病患之護理經驗。若瑟醫護雜誌,6(1),96-106。  延伸查詢new window
3.龔宥潔、柯薰貴(20140200)。一位因車禍致脊髓損傷患者之照護經驗。志為護理,13(1),101-110。  延伸查詢new window
4.陳慧玲、鍾玉珠(20110400)。一位頸髓損傷患者復健期的護理經驗。領導護理,12(1),65-77。  延伸查詢new window
5.張文芸、黃必先(20070900)。運用宗教療法照護一位脊髓損傷病患無望感之護理經驗。長庚護理,18(3)=59,423-432。new window  延伸查詢new window
6.Chen, H. Y.、Boore, J. R. P.(2007)。Establishing a super-link system: Spine cord injury rehabilitation nursing。Journal of Advanced Nursing,57(6),639-648。  new window
7.Bracken, M. B.(2012)。Steroids for acute spinal cord injury。Cochrane Database of Systematic Reviews,18(1),1-51。  new window
8.謝麗卿、王玉女(20081200)。照顧一位脊髓損傷合併四肢癱瘓患者的護理經驗。長庚科技學刊,9,49-62。  延伸查詢new window
9.Walker, J.(2009)。Spinal cord injuries: Acute care management and rehabilitation。Nursing Standard,23(42),47-56。  new window
10.Molliqaj, G.、Payer, M.、Schaller, K.、Tessitore, E.(2014)。Acute traumatic central cord syndrome: A comprehensive review。Neuro-Chirurgie,60(1/2),5-11。  new window
11.Hagen, E. M.(2015)。Acute complications of spinal cord injuries。World Journal of Orthopedics,6(1),17-23。  new window
12.Hadley, M. N.、Walters, B. C.(2013)。Introduction to the guidelines for the management of acute cervical spine and spinal cord injuries。Neurosurgery,72(2),5-16。  new window
13.陳耀仁、陳竑曄(20140600)。Influence of Pain on Depression and Quality of Life in Patients with Spinal Cord Injury。臺灣復健醫學雜誌,42(2),81-87。  new window
研究報告
1.衛生福利部統計處(20170619)。105年主要死因統計結果分析。  延伸查詢new window
其他
1.American Spinal Injury Association(2014)。International standards for neurological classification of spinal cord in jury,http://www.asia-spinalinjury.org/elearning/ASIA_ISCOS_high.pdf#search="American Spinal Injury Association ASIA impairment scale"。  new window
 
 
 
 
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