Ineffective Health Care for laryngectomy

Ineffective Health Care for laryngectomy

<Definition>
It is difficult for patients and their families who need medical treatment due to illness or sequelae, management of symptoms, recovery of physical function, and maintenance of physical function to incorporate treatment into their daily lives, and it tends to be insufficient to lead the desired life. The condition is called “ineffective health care”.

<Differences in how to use “ineffective health maintenance” and “ineffective health management”>
“Ineffective health maintenance” is used for individuals who want to change their unhealthy lifestyle such as overeating, lack of exercise, and smoking, and is used for primary prevention to prevent the onset of illness.
“Ineffective health care” is used for patients who need education on self-management of illness or health condition.

<Nursing care plan>

Target
Acquire the knowledge and skills necessary for self-management
Can notice and deal with problems
Get the support you need after pharyngectomy

Observation plan
1. Age, cognition, comprehension
2. Medical condition, treatment content, presence / absence and degree of complications, impact on ADL and IADL
3. Medical history
4. Examination data (chest X-P, WBC, CRP)
5. Understanding of tracheal management
-Amount of sputum, properties, sputum production status
-Self-suction method, management method
-The size of the tracheal foramen, the condition of the skin
-Indoor humidification status and method
6. Defecation status
7. Understanding how to deal with abnormalities
8. Communication method (written conversation, dial, etc.)
9. How to utter
10. How patients and their families perceive diseases and treatments
11. Presence or absence of anxiety
12. Understanding and reaction of instruction content
13. Contents of self-management practiced
-Patient situation, cognition
-How to catch the patient
-Is the patient’s behavior correct?
-Are you able to continue your actions?
14. Living conditions before hospitalization
-Life cycle
-Habitual behavior (dietary habits, smoking, drinking, etc.)
-Home environment, local environment, transportation
-Profession
-hobby
-Home role
-Social role (working / schooling situation)
-With or without religion
-Knowledge and understanding of family and key persons
-Relationship with family
-Family support status
15. How is the illness or disability described?
16. Workplace (school) environment
17. Adjustment of working hours and learning content
18. With or without social support
19. Economic situation
20. Whether or not to use the public subsidy system for medical expenses

Care plan
1. Listen to the patient’s thoughts
2. Treat with respect for the patient’s thoughts
3. Consider communication methods with the patient
4. Introduce the patient association and make adjustments so that you can participate if you wish.
5. Help patients understand their own condition by using teaching materials for self-management after discharge.
6. Coordinate a place to explain to the whole family to prevent differences in understanding between families
7. Hold a pre-discharge conference in collaboration with multiple occupations
-Support patients and their families to express their needs and anxieties, and speak and adjust when necessary.
-Tell local supporters about discharge guidance
8. When necessary, stay out of the exam before discharge to clarify and solve problems related to self-management.

Education plan
1. Make sure the patient / family is ready to accept education
2. Educate patients and their families in the way and environment they desire
3. Provide emotional support and provide education according to the psychological reactions of patients and their families.
4. Prioritize the problems of patients and their families and what they want to know, and give the following guidance in collaboration with multiple occupations.
> Explain the communication method
-Writing and using the dial, etc.
-Voice method
> Explain the management of tracheal holes
-Necessity of observing the tracheal foramen
-Humidification and protection methods
-How to remove sputum
> Explain the living environment
-Temperature / humidity adjustment
-Keep a clean room
> Explain that water does not enter the tracheal pores
-Notes on meals
-Notes on bathing
> Providing information about the patient association
> Providing information about social support
> Explain how to respond in the event of a disaster


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