1例基于需求视角下老年共病患者的术后延续护理

An Elder with Multiple Comorbidity’s Postoperative Transitional Care from the Perspective of Needs

摘要: 目的：总结1例老年共病患者胆囊切除、胆总管T管引流术后的延续护理经验。方法：对我科1例老年共病患者术后的延续护理方法进行总结和分析。结果：在全面评估患者及照护者需求后制定整体化的延续护理措施，经过2个月的延续护理干预，成功返院拔除留置T管，术口愈合良好，吞咽功能、躯体活动度好转，家属照护技巧改善，患者病情稳定。结论：居家患者的延续护理需求和住院患者的存在差异，通过充分评估居家患者的需求后制定相应的护理措施，不但能满足居家患者的居家护理需求，对于缓解患者病情、改善患者结局、提升家属照护技巧、减少医疗开支等有积极的意义。

Abstract: Object: To summarize the care methods of an elder with multiple comorbidity who had cholecystectomy and Indwelled T tube. Methods: The transitional care methods of an elder with multiple capability who had cholecystectomy and Indwelled T tube in our department were summarized and analyzed. Results: According to the full-scale nursing evaluation results, individualized nursing measures were formulated and implemented for 2 months, then the patients who were in stable condition. T tube was pulled out safety, surgical incision healed in good condition, dysphagia and Physical activity level were improved, and family care skill was promoted. Conclusion: The patient’s home-based care need is different from the hospital, by evaluating the all-sided nursing needs at home and giving relevant nursing intervention can meet the home nursing needs to some extent. On the other hand, the transitional care is benefit for relieving the progression of disease, improving the outcome of patient, promoting family care skills and reducing medical expense and so on.