一位COVID-19高齡病人負壓隔離照護經驗

Nursing an Elderly Patient in a COVID-19 Negative-Pressure Isolation Ward

陳瑩眞(Ying-Jen Chen) ； 鍾宜真(Yi-Jen Chung) ； 劉雅絃(Ya-Hsien Liu)

《榮總護理》 38卷3期 (2021/09) Pp. 241-248

https://doi.org/10.6142/VGHN.202109_38(3).0003

摘要

COVID-19已是全球大規模高風險傳染性疾病，確診者需要立即住院隔離。本文是探討一位高齡女性病人確診COVID-19，面臨需強制住院隔離的照護經驗。筆者在負壓隔離病房，發現病人因住院隔離及感染症狀，不了解疾病進展及治療期程，造成身心衝擊。護理期間為2020年1月25日至2月29日，以Gordon十一項功能性健康型態進行整體評估，確立病人有社交隔離、現存性感染、焦慮等的健康問題。照護期間與病人共同計畫日程表及提供社交通訊管道、日常生活所需以及隔離室內硬體設備，減輕病人的社交隔離感；支持性療法改善症狀及配合醫囑及藥物治療，給予疾病衛教，提升疾病認知及保健措施，改善肺部現存性感染；發揮同理心，鼓勵病人說出感受及期待，主動關懷身心靈需求，降低焦慮。期望藉此照護經驗，供護理人員照護新興傳染病且隔離病人之參考，使病人獲得良好照護品質。

關鍵字

COVID-19 ； 高齡 ； 社交隔離

並列摘要

COVID-19 is a high-risk infectious disease prevalent worldwide, and patients diagnosed as having this disease must be hospitalized in a negative-pressure isolation ward immediately. This paper concerns the nursing experience for an elderly female patient who was diagnosed as having COVID-19 and faced mandatory isolation. The nursing period was from January 25 to February 29, 2020. During the isolation period, the patient did not have social contact and did not understand the progress of the disease or the treatment timeline, which caused physical and mental health problems. This study performed an overall assessment of the patient on the basis of Gordon's 11 functional health patterns. It determined that in addition to social isolation, the patient had coexisting infections and anxiety. On the basis of this experience, several actions are recommended to improve care for patients in isolation wards. During the nursing period, nurses should plan a schedule together with the patient and provide communication channels, daily life needs, and isolation room hardware equipment to reduce the patient's sense of social isolation. They should provide supportive therapy and health education, which can ameliorate symptoms, improve medication adherence, and improve cooperation with the doctor's orders. Disease awareness and health care measures can ameliorate coexisting lung infections. Furthermore, nurses should take more initiative to care for patients' physical and mental needs, exert empathy, and encourage patients to express their feelings and expectations in order to reduce their anxiety. This nursing experience can serve as a reference for caring for patients in isolation with emerging infectious diseases.

並列關鍵字

COVID-19 ； advanced age ； social isolation

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