一位新住民罹患克隆氏症接受居家靜脈營養之照護經驗

Experience of Caring for a New Resident Suffering from Crohn's Disease Receiving Home Parenteral Nutrition

林曉伶(Hsiao-Ling Lin) ； 陳繪竹(Hui-Zhu Chen) ； 潘慧娟(Hui-Chuan Pan)

《高雄護理雜誌》 33卷3期 (2016/12) Pp. 85-96

https://doi.org/10.6692/KJN-2016-33-3-9

摘要

本文描述一位新住民罹患克隆氏症，因腸道反覆發炎及吸收差，導致體液電解質流失及營養不良而入院，於病情穩定後協助個案執行首次居家靜脈營養照護，因新住民尋求健康照護及社會支持系統不足，又面臨喪夫而失去經濟支柱及對疾病進展不了解，使個案產生極大心理壓力。護理期間自2013年10月9日至11月2日，運用Gordon十一項健康型態功能評估，確立個案營養少於身體所需、知識增進的準備度、個人因應能力失調等健康問題。照護中了解案母因身分問題無法長期留台照顧，因此拍攝影片及運用照片，指導個案學習居家靜脈營養相關注意事項及技術，並以回覆示教來確認是否執行正確。另外，針對個案社會支持不足之處，筆者也與社工師共同協助個案申請民間慈善機構補助款，降低因經濟產生的壓力，使其成功回歸家庭生活。

關鍵字

克隆氏症 ； 居家靜脈營養

並列摘要

We report the successful home care experience for a new resident with Crohn's disease. She was admitted due to an inflammatory bowel disease with severe electrolyte imbalance and malnutrition. She received parenteral nutrition with home care after discharge from our facility. The patient was stressed about the unfamiliar disease (Crohn disease) and faced severe financial crisis. As an immigrant, she also lacked sufficient familial support. The home care was performed between Oct. 9th, 2013 to Nov. 2nd, 2013. We evaluated the patient with the eleven criteria of the Gordon Health functional assessments. She had insufficient nutrient intake and lacked correct acknowledgement about her bowel disease, She also lost the capability to manage her daily life. We also understood that her mother could not provide sufficient familial support due to her identity as a new resident. We instructed the patient with videos and photographs about her parenteral nutrition. We also confirmed her progress via a mutual communication manner. In addition, for the case of the social support deficiencies, with the coordination of home care, a social worker, and non-governmental charitable organizations, we successfully helped the patient return to her normal daily life.

並列關鍵字

Crohn's disease ； Home parenteral nutrition