- 期刊
協助一位使用居家靜脈營養病患出院準備服務之護理經驗
Nursing Experience: Discharge Planning for a Home Parenteral Nutrition Patient
摘要
本篇個案報告是描述一位胃癌術後併發腸阻塞問題，導致無法由腸道攝取營養之病患，在病情穩定後，協助居家靜脈營養出院準備服務，使其能順利返家獲得適切的後續照護，達到最佳的健康狀態與生活品質。照護期間自2007年2月15日至2007年3月11日，筆者針對個案生理、心理、社會及靈性等層面進行整體性評估與資料收集，發現個案有營養狀況少於身體需要、無望感及健康尋求行為等健康問題。在照護過程中，運用出院準備服務概念，以個案之健康問題作為護理計畫的軸心，利用主動關懷、傾聽等方式瞭解個案與案妻的需求，教導居家靜脈營養照護相關知識與技能，增進自我照顧能力及協助壓力調適。並於出院後，藉由個案回診及以電話訪問等方式追蹤病患居家靜脈營養使用情形，使其能獲得持續性照護。期藉此照護經驗能讓護理人員了解較為複雜的居家靜脈營養出院準備服務之過程，提供日後對此類病患在居家靜脈營養照護上能有更明確的指引，讓病患及家屬能夠實際操作並依循靜脈營養照護原則，以確保病患能安全的居家使用靜脈營養治療，進而提升生活品質。
並列摘要
This case report describes the nursing experience regarding home parenteral nutrition for a patient whose intestine failed to absorb nutrition due to ileus after the surgery for gastric cancer under discharge planning after the patient's condition became stable. During the nursing care period, from February 15th 2007 to March 11th 2007, comprehensive assessments were made regarding the patient's physical status, mental health, social status, and spiritual life. Some health issues were found, such as the patient's altered nutrition being less than body requirements, feelings of hopelessness, and health-seeking behaviors. Consequently, suggestions were made for the nursing process, including utilization of the client-centered discharge planning services. Active attention was paid to understand the requirements of the patient and his wife, equip them with skills and knowledge to administer home parenteral nutrition, enhance the patient’s ability in self-care, and assist in stress management. The patient's health and home parenteral nutrition was continually monitored through telephone interviews and return visits to the clinic. The nursing experience learnt here is insightful and worth sharing. We have outlined clear and practical advice to manage complicated cases that require discharge planning to accommodate home parenteral nutrition delivery. This client-centered approach will genuinely improve patient's understanding and compliance to use home parenteral nutrition safely and correctly.