照顧一位再復發多發性硬化症個案因應壓力之護理經驗

A Nursing Experience of Patient with Multiple Sclerosis Relapsed Coping with Stress

邱詩涵(Shin-Han Chiu) ； 黃麗靜(Li-Ching Huang) ； 袁雅怡(Ya-I Yuan)

《志為護理-慈濟護理雜誌》 17卷1期 (2018/02) Pp. 94-105

摘要

本文描述照護一位48歲女性，因遭遇多發性硬化症復發導致身體功能改變與面對壓力因應的護理經驗。護理期間由103年3月1日至3月15日，筆者經由照護個案過程中進行系統性的觀察、運用會談及傾聽等技巧收集資料與分析，藉由Gordon十一項功能性健康型態作為評估與分析，發現個案有「身體活動功能障礙」、「排尿型態改變」、「知識缺失」及「無效性因應能力」等健康問題。筆者透過個別化的護理措施，運用「建立希望」策略，強化家庭支持系統與醫療團隊合作，引導個案正向思考，提升自信心，增進個案自我照顧能力，協助個案面對罕見疾病所造成的肢體障礙與心理壓力，增進生活品質。期望藉此個案的護理經驗，提供臨床護理人員照護此類病人之參考。

關鍵字

血液透析 ； 動靜脈瘻管 ； 阻塞率

並列摘要

The purpose of this article was to discuss the nursing experience of a 48-year-old subject who suffered from recurrent multiple sclerosis that led to the onset of body function changes and the need of stress coping strategies. The nursing period was from March 1^(st) to 15^(th), 2014. By collecting data via systematic clinical observations, interviews, and listening during direct care and using Gordon's 11-item functional health pattern as a framework for assessment and analysis, the health problems were identified as impaired physical mobility, altered urinary elimination, knowledge deficit, and inefficient coping. Through individualized nursing care, establishment of hope, strengthening of family support system in cooperation with the medical team, guidance on positive thinking, the author was able to instill self-confidence in the patient, enhance the patient's self-care ability to ameliorate physical impairment and psychological stress from the rare disease, and raise quality of life. This case report can serve as a reference for clinical nurses when facing similar cases.

並列關鍵字

coping ； multiple sclerosis ； nursing stress