運用自我處理原則於一位氣喘學童之護理經驗

The Nursing Experience of Applying Self-management Principles to a School-aged Child with Asthma

陳雅怜(Ya-Lin Chen) ； 蔡佳玲(Jia-Ling Tsai) ； 李銘櫻(Ming-Ying Lee)

《長庚護理》 20卷4期 (2009/12) Pp. 498-508

https://doi.org/10.6386/CGN.200912_20(4).0008

摘要

本文是運用自我處理原則於一位反覆急性氣喘發作學童之護理經驗，藉由參與性觀察與個別訪談，並運用整體性健康評估來收集資料，分析發現個案有「低效性呼吸型態」、「情境性低自尊」、「家庭治療計劃處置不當」等健康問題，筆者運用自我處理原則來教導個案及案母學習氣喘自我處理行爲，包括預防行爲、處理行爲與評估症狀行爲，考量個案及家庭的照護需求，藉由氣喘認知分析和個案共擬目標，配合玩偶及教具使用個別衛教，提供個案及案母氣喘症狀評估與症狀自我處理、藉由簡易之自我監測系統評估病情嚴重度，並藉由適當氣喘自我處理及居家護理技巧來避免氣喘再度急性發作，最後案母能對氣喘控制表達關注及對降低氣喘反覆發作採取具體改善行動，顯示自我處理行爲的正向照護成效，有助於病重及家屬能獲得較佳的照護品質及氣喘控制。

關鍵字

學齡期兒童 ； 氣喘發作 ； 自我處理行爲

並列摘要

This article reported nursing experience of applying self-management principles to a school-aged child with recurrent acute asthma attack. During the nursing period, we collected data from participant observation and individual interview. The holistic health assessment was used to identify health problems. The child had three major nursing health problems, including ”ineffective breathing pattern”, ”situational low self-esteem”, and ”ineffective management of therapeutic regimen: families”. The authors utilized self-management principles to educate the child and his mother to learn asthma self-management behaviors, including preventive behaviors, managing behaviors and assessing behaviors. According to individual caring needs, we provided the case with appropriate nursing intervention. Through the cognitive analysis of asthma, we set goals with the child. We used puppet and teaching aids to conduct face-to-face health education. The child and his mother learned of asthma symptom assessment and self-management. The mother utilized simple self-monitoring system to assess illness severity, then appropriately performed asthma self-management and home nursing skills to avoid acute asthma attack. The mother finally could express concerns about asthma control and action. We found positive effect in asthma self-management behaviors. It could improve the quality of life and asthma control for the child and his families.

並列關鍵字

school-aged child ； asthma attack ； self-management behavior