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澄清醫護管理雜誌

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篇名 一位跳樓自殺導致顱內出血青少年患者之護理經驗
卷期 17:2
並列篇名 Nursing Experience of a Teenager with Intracranial Hemorrhage Caused by Jumping off a Building in a Suicide Attempt
作者 魏榛誼李彩緣陳宥蓁陳珈諭洪尚祐
頁次 058-067
關鍵字 自殺顱內出血無效性因應能力無望感SuicideIntracranial hemorrhageIneffective coping abilityHopelessness
出刊日期 202104

中文摘要

本文為描述一位青少女因與男友情感糾紛而爭吵,雙方無法達成共識,情緒過於激動採取跳樓自殺行為,導致顱內出血住院之照護經驗。護理期間自2018年8月15日至2018年8月25日透過會談、觀察、傾聽及直接照護收集資料,運用Gordon十一項功能性健康型態進行護理評估,確認個案因自殺導致顱內出血有多項護理問題,考量篇幅,依健康照護需求的優先順序,故僅針對「身體活動功能障礙」、「無效性因應能力」及「無望感」護理問題進行討論。護理過程中,藉由引發參與醫療活動意願,與個案訂定每日運動計畫的措施,教導個案漸進式活動、增強活動力,學習自我照顧能力技巧,克服身體功能上的障礙;主動積極關懷,密切觀察情緒行為變化,引導訴說內心想法,教導穩定情緒之技巧,教導因應壓力技巧,正向面對問題;藉由傾聽和陪伴,引導表達內心想法,提供紓壓方式及正向支持,並鼓勵個案參與治療計畫及自我照護,提昇自信心,促進個案自我肯定、建立自我價值,改善無望感。建議跨團隊合作,提供維持妥善醫療照護,並協助建立良好家庭關係,予出院前續轉介相關醫療團隊協助收案,定期追蹤治療動向、關懷患者病況,預防再次自我傷害。

英文摘要

In this study, we describe the nursing experience of a teenage girl hospitalized for intracranial hemorrhage caused by jumping off a building in an attempt to commit suicide. She quarreled with her boyfriend because of emotional entanglements, and the two could not reach a consensus. She was driven to the brink of madness and committed suicide. The nursing period was from August 15 to August 25, 2018; we collected data through interviews, observations, listening, and direct care. Further, we adopted Gordon’s eleven functional health patterns for nursing evaluation. It was confirmed that the suicide attempt caused intracranial hemorrhage, and many problems needed to be addressed during the nursing period. Considering the limited space and priority of health care needs, we only discussed three nursing issues, namely “impaired physical mobility,” “ineffective coping,” and “hopelessness.” In the process of nursing, by arousing the willingness of the patient to participate in medical care activities, making daily exercise plans with the patient, and instructing the patient to increase movements gradually so as to enhance mobility, we enabled the patient to learn self-care skills and overcome the obstacles in her physical function. We actively expressed our concern for the patient, carefully observed the changes in her emotions and behaviors, guided her to express her inner thoughts, as well as taught her skills of stabilizing emotions, coping with stress, and facing problems positively. Through listening and companionship, guiding the patient to express her inner thoughts, providing ways of stress relief and positive support, as well as encouraging her to participate in treatment schemes and self-care, we enhanced her self-confidence, promoted self-affirmation, helped establish self-value, and relieved hopelessness. It is recommended to work multi-disciplinarily to provide and maintain proper medical care, help the patient build a good family relationship, refer the patient to relevant medical teams for subsequent care before discharge, regularly track the treatment progression, express concern for the patient’s conditions, and prevent the patient from self-harming again.

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