- 期刊
照護一位初患馬凡氏症患者主動脈剝離術後之護理經驗
Nursing Experience from Caring for a Patient with Marfan Syndrome and Aotic Dissection
摘要
本文描述一位年輕女性，因運動時胸悶發現B型主動脈剝離入院手術，後診斷為馬凡氏症之照護經驗，個案除面對術後疼痛，短時間須接受罹病心態及擔憂未來感到焦慮等而引發作者書寫動機。護理期間自2022年10月7日至2022年10月18日，運用Gordon十一項健康型態評估，以觀察、會談、身體評估技巧進行整體性評估，確立有：急性疼痛、活動無耐力與焦慮等健康問題。照護過程以轉移注意力方式減輕疼痛不適；採漸進式活動共同訂立復健訓練計劃來增加活動耐力，並教導返家自我照顧技巧；與個案建立良好護病關係，疾病處置相關認知，安排網路病友會與罕見疾病照護單位分享經驗，運用同理心傾聽個案困擾與感受，引導正向思考及肯定自我價值，建立個案信心並鼓勵及邀請家人陪伴與學習，希望藉由家庭系統支持，進而減輕焦慮程度，以提供完善且持續的照護品質並作為日後照護此類個案之參考。
並列摘要
This article describes the care experience of a young woman who was admitted to the hospital after experiencing chest tightness during exercise, leading to the diagnosis of type B aortic dissection and Marfan syndrome. In addition to managing postoperative pain, the patient faced psychological challenges, including anxiety from having to quickly come to terms with her diagnosis and concerns about her future. This prompted the motivation for writing the report. During the nursing period from October 7th to 18th in 2022, Gordon's 11 Functional Health Assessment was applied to collect data through observation, interview, and physical assessment. The issues established were "acute pain", "activity intolerance" and "anxiety". Remedies include divert attention to reduce pain; develop a rehabilitation training plan to increase activity endurance; teach self-care skills at home; establish a good nursing relationship with the patient to improve knowledge about disease management; arrange for patients sharing experiences; listen to the patient's problems and feelings with empathy; guide positive thinking and self-affirmation to increase confidence, and strengthen family support system to reduce anxiety. We hope to share the disease diagnosis and care process about this case to provide future reference.