運用醫病共享決策於一位初診斷多發性硬化症患者之護理經驗

A Nursing Experience Caring with a Newly Diagnosed Multiple Sclerosis Patient Using Shared Decision-making in Medicine

陳怡君(Yi-Jun Chen) ； 葉美杞(Mei-Chi Yeh) ； 吳玉欣(Yu-Hsin Wu)

《高雄護理雜誌》 37卷3期 (2020/12) Pp. 68-81

https://doi.org/10.6692/KJN.202012_37(3).0007

摘要

多發性硬化症為無法治癒的罕見疾病，發病後肢體功能會逐漸喪失，甚至癱瘓，對病人身心及其家庭產生極大衝擊。個案初次診斷為多發性硬化症的青少女，照顧期間自2017年10月30日至11月27日，個案出現身體自主控制能力受限，情緒慌亂低落。筆者運用生理、心理、社會及靈性四層面進行整體性評估，歸納出身體活動功能障礙、焦慮及知識缺失之主要健康問題。藉由提供個別性護理，運用醫病共享決策概念，藉由各職類人員參與提供專業知識，給予病人完整的疾病及不同治療方式之認知，使其能接受且正向因應疾病，增進自我照顧，延緩失能及殘疾，提升生活品質。藉此經驗，提供臨床護理人員照顧罹患重大疾病病患之醫病共享決策模式參考。

關鍵字

多發性硬化症 ； 身體活動功能障礙 ； 焦慮 ； 醫病共享決策

並列摘要

Multiple sclerosis (MS) is a rare disease without effective therapy. After onset, limb functioning is progressively lost, even leading to paralysis, having great impact physically, mentally and spiritually, on patients and their families. This case was a teenager diagnosed with MS with the period of care from October 30 to November 27, 2017. The patient's ability to control her own body was limited, and her mood was disturbed. The author assessed physical, psychological, social and spiritual dimensions to summarize the main health problems of physical activity dysfunction, anxiety and lack of knowledge. By providing individual care, using the concept of shared decision-making and providing professional knowledge by the various categories of the medical staff, the patient developed a more complete awareness about the disease and different treatments, accepted and responded to this disease positively, enhanced self-care behavior and had delayed disability with improved quality of life. Based on this experience, clinical nurses could provide more targeted care of patients with major diseases by this shared decision-making model.

並列關鍵字

multiple sclerosis ； physical activity dysfunction ； anxiety ； Shared decision-making

參考文獻

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