本文以歐氏自我照顧理論（Orem's self-care theory）護理一位因感染腸病毒導致心肺功能衰竭之男童，於住院期間教導案母執行氣切及鼻灌食等技巧的居家照護經驗。個案入院初因處於急性休克期，故施行開心手術及體外循環等治療，並以呼吸器維生，然因無法自行有效性呼吸及排除呼吸道分泌物，於恢復期時行氣切術，為使家屬達日後自我照顧之功能，故教導家屬居家照顧為護理工作重點；此外，因疾病傷及第九與第十對腦神經，故有吞嚥障礙。筆者應用歐氏理論提供身、心、靈及社會整體評估，確立個案自我照顧缺失護理診斷採完全代償性護理措施解決呼吸道清除功能失效、吞嚥障礙等問題；以部分代償性護理措施滿足娛樂活動缺失及家庭運作過程改變的需求；經完全代償轉變為部分代償性護理措施協助案母在疾病限制下，達成自我照顧的目標執行居家自我照顧。
The article introduced the care of a sick boy by Orem's self-care theory who had cardiopulmonary failure due to infected by enterovirus. We instruct his parents the tricks concerning tracheostomy and nasogastric tube feeding. The patient received open heart and Extracorporeal membrane oxygenator (ECMO) surgery because he was at shock state in the beginning of admission to our hospital. During the shock period, his respiratory function was supported by a ventilator. As the inefficient breath, he received tracheostomy after his shock had resolved. In order to let his family own the ability of self-care, the nursing key point is to instruct the family about home care. Besides, the patient had swallowing difficulty because his cranial nerve IX and X were injured by enterovirus. The authors imply Orem's self-care theory to evaluate the patient's physical, psychological, and social function, to make sure the nursing diagnosis about self-care deficiency. We adopted wholly compensatory system to resolve problems such as ineffective airway clearance and impaired swallowing. On the other hand, we adopted partly compensatory system to make up for deficiency of diversional activity and interrupted family process. To perform self-care at home under the limitation of illness, wholly compensatory system was converted to partly compensatory system.
