運用關懷照護照顧一位急性心肌梗塞病患之護理經驗

The Nursing Experience of Applying Caring to Acute Myocardial Infarction Patient

蕭雅文 ； 何岱爭 ； 張志明 ； 楊宜霖

《領導護理》 8卷1期 (2007/06) Pp. 96-107

https://doi.org/10.29494/LN.200706.0010

摘要

本篇個案報告主要在探討一位73歲的老人因急性心肌梗塞在加護病房的照護過程。護理期間自94年4月9日至94年4月28日，藉由觀察、訪談及運用Gordon十一項功能性健康型態評估等收集主客觀資料並確立問題。在護理過程中發現個案因急性心肌梗塞在生理上產生胸痛、喘等不適症狀，在心理上也因環境改變及擔心疾病產生焦慮，因此歸納出個案主要的護理問題有：「氣體交換功能障礙」、「心肌組織灌流改變」、「睡眠形態紊亂」、「焦慮」及「預期性哀傷」。透過護理人員主動關懷、傾聽、及尊重等之關懷照護行爲，並運用專業提供合宜、舒適的護理措施，使病患胸痛得到緩解外，也降低了焦慮與不安的症狀，增加病患睡眠時聞。筆者更運用了關懷行爲，促使個案從拒絕檢查及治療到接受了侵入性治療，讓病患在住院過程中獲得良好的醫療照護，故藉此個案報告的護理經驗提出與護理人員分享，以做爲日後照護此類病患參考。

關鍵字

關懷照護 ； 急性心肌梗塞 ； 加護病房

並列摘要

This article describes the nursing experience in caring for a 73-year-old male with acute myocardial infarction disease in ICU, who was under nursing care from April 9 to 28, 2005. patient's data was collected and carefully evaluated through verbal conversation and observation based on Gordon's 11 criterias for a functional health state. Patient appeared to have chest pain and short of breath because of myocardial infarction on the physiology during hospitalization period and also exhibited, anxiety secondary to changes in environment and worries about disease. Nursing problems such as gas exchange impaired, tissue perfusion altered (cardio), sleep pattern disturbance, anxiety and grieving anticipatory were clearly established. Through the deployment of caring behavior, listening actively, respecting for the patient and also made use of professional and suitable nursing interventions, patient’s chest pain was alleviated; worries and anxiety were also greatly reduced and as a consequence sleeping time was increased. The author of this article was able to provide caring to help him accept invasive treatments, turning away from refusing behavior before, The patient has acquired a good medical care during the period of staying in hospital. By reporting the nursing experience of this case, we hope the knowledge gained could be shared and referenced by others.

並列關鍵字

concern with caring ； acute myocardial infarction ； intensive care unit