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題名:照顧一位初次腦中風個案之護理經驗
書刊名:長庚護理
作者:利怡慧陳淑華周嫚君陳秀偵
作者(外文):Li, Yi-huiChen, Shu-hwaChou, Man-chunChen, Shiu-chen
出版日期:2018
卷期:29:3=103
頁次:頁431-441
主題關鍵詞:腦中風吞嚥困難護理經驗StrokeDysphagiaNursing care
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:12
  • 點閱點閱:3
本文敘述一位初次腦中風導致吞嚥困難、肢體無力、構音困難之護理經驗。照護期間為2015年12月3日至16日,透過傾聽、觀察及身體評估等方式,運用Gordon十一項功能性健康型態評估收集與分析資料。確立健康問題為吞嚥障礙、身體活動功能障礙、言辭溝通障礙、知識缺失及身體心像紊亂,運用跨領域團隊合作,與個案及家屬共同擬定照顧計畫,指導個案口腔運動、吞嚥及進食技巧、平衡訓練、肢體活動訓練及構音技巧等,並探究不按時服降血壓藥原因及面對疾病所致的心理衝擊主動了解病人內心感受及需求,鼓勵參與自我照顧計畫,提供相關訊息,改變中風前高血壓認知,及協同家人的支持,激發病人維持復健的動力,重新面對中風的影響,建立正向自我概念及疾病照護認知。期望藉此護理照護經驗日後能提供臨床照護之參考。
This article described a nursing care of a first time stroke patient suffering from dysphagia, weak limbs, and dysarthria. From December 3 to 16, 2015, the author adopted Gordon's 11 functional health pattern assessment to collect and analyze the data of the patient with the strategies of interview, observation, and physical assessment. The confirmed major physical difficulties were impaired swallowing, physical mobility and verbal communication, as well as deficient knowledge, and disturbed body image. By conducting multi-disciplinary cooperation, the author established a caring plan with the patient and the family. First, the author instructed the patient in oral motor exercise, skills of swallowing and eating, balance and limb activity training, as well as articulation skill. Second, the author looked into the reason of the patient not taking medications on time and the psychological impact when he faces the illness, so that the author could understand how the patient felt and what were needed, and encouraged the patient participate in self-care plan. Furthermore, the author provided the patient with relevant information to change his understanding of hypertension. With the support and cooperation from the family, the author had promoted the patient's motive for rehabilitation, and the patient began to re-confront the impact of stroke. The experience can be a reference for similar nursing cares in the future.
期刊論文
1.Borthwick, S.(2012)。Communication impairment in patients following stroke。Art & Science,26(19),35-41。  new window
2.陳夏蓮、蔡仁貞(20120200)。症狀經驗、病因解釋與治療遵從行為--以高血壓病人為例。護理雜誌,59(1),5-10。new window  延伸查詢new window
3.賴怡君、王桂芸、陳金彌(20111100)。吞嚥困難之概念分析。源遠護理,5(2),56-62。  延伸查詢new window
4.詹淑雅、劉芹芳、金繼春(20110400)。身體心像紊亂之概念分析。新臺北護理期刊,13(1),63-72。  延伸查詢new window
5.邱明發、顏兆熊(20111100)。缺血性腦中風急性期後之處置。當代醫學,38(11)=457,851-857。  延伸查詢new window
6.Yew, K. S.、Cheng, E. M.(2015)。Diagnosis of acute stroke。American Family Physician,91(8),528-536。  new window
7.蔡惠如、曾詩蘋、王守玉、張瑛瑛、趙玉環(20160400)。探討首次腦中風病人初期之調適過程。護理雜誌,63(2),103-112。new window  延伸查詢new window
8.陳建志、陳亮宇、張馨丰、鄒永恩、陳登郎(20150700)。以急性單側聲帶麻痺為初始表徵之外側延髓梗塞。臺灣耳鼻喉頭頸外科雜誌,50(3),181-185。  延伸查詢new window
9.盧采臻、張麟鳳、洪蘆妍、彭淑苹(2015)。護理人員協動執行腦中風病人吞嚥訓練之指引及現況。榮總護理,32(2),202-207。new window  延伸查詢new window
10.Veerbeek, J. M.、Wegen, E. V.、Peppen, R. V.、Wees, J. V.、Hendriks, E.、Rietberg, M.、Kwakkel, G.(2014)。What Is the Evidence for Physical Therapy Poststroke? A Systematic Review and Meta-Analysis。PLoS On,9(2),e87987。  new window
11.Maeshima, S.、Osawa, A.、Miyazaki, Y.、Takeda, H.、Tanahashi, N.(2012)。Functional outcome in patients with pontine infarction after acute rehabilitation。Journal of the Neurological Sciences,33(4),759-764。  new window
12.Kernan, W. N.、Ovbiagele, B.、Black, H. R.、Bravata, D. M.、Chimowitz, M. I.、Ezekowitz, M. D.、Wilson, J. A.(2014)。Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the american heart association/american stroke association。Stroke,45(7),2160-2236。  new window
13.Gibbon, B.、Gibson, J.、Lightbody, C. E.、Radford, K.(2012)。Promoting rehabilitation for stroke survivors。Nursing Times,108,12-15。  new window
研究報告
1.衛生福利統計專區(20170618)。105年死因統計年報。  延伸查詢new window
其他
1.台灣腦中風學會(2015)。腦中風危險因子防治指引:高血壓2015,http://www.stroke.org.tw/guideline/guideline_index.asp。  延伸查詢new window
 
 
 
 
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