一位遺傳性貧血引發胸內髓外造血囊腫老年人之護理經驗

本文旨在分享一位遺傳性球狀紅血球性貧血(hereditary spherocytosis)引發胸內髓外造血囊腫(intrathoracic extramedullary hematopoiesis masses)老年人，因併發肋膜積水(Pleural Effusion)導致呼吸困難反覆入院之護理經驗。護理期間從2006年3月6日至2006年3月14日，經由生理、心理、社會及靈性層面之整體性護理評估，確立個案面臨低效性呼吸型態、無力感、潛在危險性孤寂等主要護理問題。為了避免個案因疾病導致身體功能喪失及反覆住院引起孤寂感，設立護理目標為改善身體不適，增進自我照顧能力，保持正常功能，促進人際關係，提升自我價值的感受。經過住院期間的照護，個案逐漸接受與疾病共存的重要性，學會運用有效性呼吸技巧，進而改善呼吸困難與不適，並且主動與醫護人員互動，不再持續出現沮喪、孤寂情緒。

關鍵字

遺傳性球狀紅血球性貧血；胸內髓外造血囊腫；肋膜積水

並列摘要

In this case report, we discuss our experience in the care of an aged hereditary spherocytosis patient with intrathoracic extramedullary hematopoiesis masses, complicated with pleural effusion. There were multiple hospital stays due to dyspnea. From the period of the 6(superscript th) to 14(superscript th) March 2006, we evaluated the male patient in physical, psychological, social and spiritual aspects. The nursing evaluation of this case presented problems of ineffective breathing pattern, powerlessness and risk of loneliness. In order to prevent disease-related declining of physical abilities and loneliness after multiple hospitalizations, we set up goals for him to alleviate/minimize/eliminate (choose the one you want-editor) his discomfort, enhance self-caring ability, maintain normal activity, promote social relationships and his sense of self-worth. After this period of caring, he accepted the importance of living with the disease, learning effective breathing patterns, and ameliorating his discomfort and dyspnea. In addition, he actively interacted with our staff and experienced no further depression or emotional loneliness.

並列關鍵字

hereditary spherocytosis ； intrathoracic extramedullary hematopoiesis masses ； pleural Effusion

國際替代計量

一位遺傳性貧血引發胸內髓外造血囊腫老年人之護理經驗

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