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題名:燒傷患者心理社會層面之照護
書刊名:長庚護理
作者:蔡沁羽張靜鳳劉姿儀徐子秦黃佳瑩洪瑜蓮
作者(外文):Tsai, Chin-yuChang, Ching-fengLiou, Zih-yiHsu, Tzu-chinHuang, Jia-yingHong, Yu-lian
出版日期:2019
卷期:30:2=106
頁次:頁160-167
主題關鍵詞:燒傷身體心像紊亂社交隔離創傷後症候群BurnBody image disturbanceSocial isolationPost-trauma syndrome
原始連結:連回原系統網址new window
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  • 共同引用共同引用:5
  • 點閱點閱:7
醫療進步使得嚴重燒傷患者的存活率大幅提升,然而燒傷事件對於心理社會的影響甚遠,長期醫護人員的關懷與照護是必要的。常見心理社會健康問題為身體心像紊亂、社交隔離及創傷後症候群。身體心像紊亂:衝突期以歐倫自我照顧模式作為照護依據,退卻期以身體心像量表評估患者對外觀改變的看法,給予正向回饋及善用輔助物修飾外觀,接受期鼓勵盡早學習獨立自我照顧與持續復健,重建期協助患者與家人重新規劃生活與未來目標。社交隔離:將家人或重要他人併入醫療團隊,建構完善支持系統、社會資源、演練社交技能,及善用社交網絡有助於產生歸屬感,以逐步回歸社會。創傷後症候群:主動關懷、同理與察覺患者的心理變化,引導正向生命態度及強化問題解決能力,指導放鬆與轉移注意力等因應技巧以緩解焦慮和無望感,輔以認知行為治療改善患者心理狀態。醫護人員秉持以家庭為中心的照護理念,不斷增進心理社會進階照護知能,適時運用護理理論於病人及家屬之身心靈照護。
Advances in medication have significantly increased the survival rate of burn patient. However, long term care is essential for the far-reaching psychosocial influence caused by burn event. The most common psychosocial health problems are body image disturbance, social isolation, and post-trauma syndrome. The phase of care of body image disturbance includes the conflict period, the retreat period, the acceptance period, and the rebuild period. The conflict period care is based on Orem's self-care theory, the retreat period can use body image scales to evaluate how the patient think about their body image change, the acceptance period encourages patient to learn self-care independently as soon as possible and continue to rehabilitate, and the rebuild period should assist patients and their family re-planning life and goals in the future. For treating social isolation, patient's family and significant others should be involved in the care system. Establishing a complete support system, using social resources, practicing social skills, and making good use of social media can promote patient's sense of belonging and return patients to the society gradually. Applying active care, empathizing and perceiving patient's psychological changes, guiding a positive life attitude, intensifying the ability of problem-solving ability, directing techniques like relaxation and attention shifting to relieve the sense of anxiety and hopelessness, with employing the cognitive behavioral therapy to improve patient's mental status are able to relieve post-trauma syndrome. Medical staff should hold a "family-centered care" faith, advance the ability of psychosocial care continuously and apply nursing theory to the biological, psychological, and spiritual care for patient and their family timely.
期刊論文
1.Price, L. A.、Milner, S. M.(2013)。The totality of burn care。Trauma,15(1),16-28。  new window
2.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
3.汪怡慧(20130600)。照顧一位顏面燒傷婦女之護理經驗。領導護理,14(2),63-72。  延伸查詢new window
4.吳佳儀、李明濱、吳其炘(20150800)。燒傷之身心問題與全人照護。臺灣醫界,58(8),9-14。  延伸查詢new window
5.歐羽珊、康豑云、蔣立琦(20141200)。重症病人及家屬創傷後壓力症之照護策略。源遠護理,8(3),75-80。  延伸查詢new window
6.羅淑芬(20150800)。嚴重燒傷病人護理處置。護理雜誌,62(4),82-88。new window  延伸查詢new window
7.王玲玲、林韶穎(20170300)。八仙樂園塵爆重度燒傷病人之急診照護經驗--個案報告。北市醫學雜誌,14(1),101-110。  延伸查詢new window
8.方昭敏、李易靜、張瓈方(20170300)。照護一位塵爆燒傷病人之護理經驗。源遠護理,11(1),52-59。  延伸查詢new window
9.周煌智(20160200)。重大災難後燒傷病人的心理重建。護理雜誌,63(1),36-41。new window  延伸查詢new window
10.溫慧敏(20160200)。迎向生命的曙光--淺談八仙塵爆事件。護理雜誌,63(1),17-21。new window  延伸查詢new window
11.Connell, K. M.、Coates, R.、Doherty-Poirier, M.、Wood, F. M.(2013)。A literature review to determine the impact of sexuality and body image changes following burn injuries。Sexuality and Disability,31(4),403-412。  new window
12.Giordano, M. S.(2016)。The lived experience of social media by young adult burn survivors。American Journal of Nursing,116(8),24-32。  new window
13.Kearns, M. C.、Ressler, K. J.、Zatzick, D.、Rothbaum, B. O.(2012)。Early interventions for PTSD: A review。Depression and Anxiety,29(10),833-842。  new window
14.Lancaster, C. L.、Teeters, J. B.、Gros, D. F.、Back, S. E.(2016)。Posttraumatic Stress Disorder: Overview of Evidence-Based Assessment and Treatment。Journal of Clinical Medicine,5(11),105。  new window
15.McRobert, J.(2012)。The psychosocial impact on patients with altered body image from burns。British Journal of Community Nursing,17(Sup12),S27-S30。  new window
16.Olszewski, A.、Yanes, A.、Stafford, J.、Greenhalgh, D. G.、Palmieri, T. L.、Sen, S.、Tran, N.(2016)。Development and implementation of an innovative burn nursing handbook for quality improvement。Journal of Burn Care and Research,37(1),20-24。  new window
17.Sareen, J.(2014)。Posttraumatic Stress Disorder in Adults: Impact, Comorbidity, Risk Factors, and Treatment。Canadian Journal of Psychiatry,59(9),460-467。  new window
18.Shepherd, L.、Begum, R.(2014)。Helping burn patients to look at their injuries: How confident are burn care staff and how often do they help?。Burns,40(8),1602-1608。  new window
19.Wiechman, S.、Hoyt, M. A.、Patterson, D. R.(2018)。Using a biopsychosocial model to understand long-term outcomes in persons with burn injuries。Archives of Physical Medicine and Rehabilitation,101(1S),S55-S62。  new window
20.Wilson, J.、Gramling, L.(2009)。The application of Orem's Self-Care Model to burn care。Journal of Burn Care and Research,30(5),852-858。  new window
研究報告
1.衛生福利部(2017)。民國105年死因統計年報。  延伸查詢new window
圖書
1.American Psychiatric Association、臺灣精神學會(2016)。DSM-5精神疾病診斷準則手冊。合記。  延伸查詢new window
2.NANDA International, Inc、黃靜微、曾詩雯、莊琬筌(2015)。NANDA International 護理診斷:定義與分類2015-2017。臺北市:華杏。  延伸查詢new window
其他
1.衛生福利部(2015)。創傷/壓力與精神健康,https://www.mohw.gov.tw/dl-1737-eef9c2c8-bb34-462a-b50b-4535ff9d27e4.html。  延伸查詢new window
2.American Psychological Association(2017)。Cognitive behavioral therapy (CBT),http://www.apa.org/ptsd-guideline/treatments/cognitive-behavioral-therapy.aspx。  new window
3.Schmid, D. M.(2016)。Post Traumatic Stress Disorder in Burn Survivors,https://www.personalinjurylaw journal.com/burn-injuries/post-traumatic-stress-disorder-inburn-survivors/。  new window
4.Schub, E.,March, P.(2017)。Scars, burns: Psychological factors,http://content.ebscohost.com/ ContentServer.asp?EbscoContent=dGJyMNLr40SeqK84zOX0OLCmr0%2Bep69SsKi4Sa6WxWXS&ContentCustomer=dGJyMPGstEquqK9RuePfgeyx43zx1d%2BI5wAA&T=P&P=AN&S=L&D=nup&K=T702608。  new window
 
 
 
 
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