照顧一位懷孕後期達理埃氏症加劇婦女身體心像改變的護理經驗

Nursing Experience Regarding the Body Image Disturbance of a Pregnant Woman in the Third Trimester with Acute Exacerbating Darier's Disease

張淯姿(Yu-Tzu Chang) ； 陳佩英(Pei-Ying Chen) ； 王秀禾(Hsiu-Ho Wang) ； 蕭玄慈(Shiuan-Tzu Hsiao) ； 詹淑雲(Shu-Yun Jan) ； 孫嘉玲(Jia-Ling Sun)

《領導護理》 19卷1期 (2018/03) Pp. 53-64

https://doi.org/10.29494/LN.201803_19(1).0005

摘要

本文探討一位懷孕後期達理埃氏症(Darier's disease; DD)急性發作歷經身體心像改變孕婦之護理經驗。個案懷孕即與DD共存，DD加劇導致極度搔癢及外觀改變，異於正常的孕婦照護，極具照護挑戰。照顧期間自2016年1月5日至20日，利用Gordon十一項健康功能評估確認個案有皮膚搔癢導致的舒適障礙及身體心像改變等護理問題。皮膚搔癢有關之舒適障礙，運用皮膚護理、藥物處置、心理支持等措施改善舒適；身體心像改變之問題，適時運用傾聽技巧，鼓勵表達內心感受，強化優點、指出改善指標、案夫支持等策略。在照顧期間積極控制症狀，預防合併症，個案逐漸走出身心改變所導致的情境，轉移至即將爲人母的心情。

關鍵字

達理埃氏症 ； 毛囊角質化 ； 皮膚癢 ； 身體心像

並列摘要

The article explores the nursing experience of caring for a pregnant woman in the third trimester with exacerbating Darier's disease (DD) The DD aggravations lead to extreme itching and changes in body image, making it a significantly different experience from that of a regular pregnancy and a challenge for nursing care. The nursing period was from January 5^(th) to 20^(th), 2016. With the assessment tool, Gordon's 11 functional health patterns, the result identified two nursing problems: a disturbance in comfort due to the extreme itching and a drastic change in body image. To alleviate the itching, the patient was provided with skincare and drug therapy, with psychological therapy to help her overcome the changes in body image. Moreover, the nursing staff employed listening skills, provided encouragement to express her feelings, identified and amplified her strengths, and solicited further support from her husband to improve her mental state. The nursing staff also aggressively controlled the signs and symptoms of the disease and prevented complications. The patient was then able to gradually overcome the body image change during the care period, with her mood ultimately shifting to that typical of a new mother.

並列關鍵字

Darier's disease (DD) ； keratosis follicularis ； skin itch ； body image

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