協助一位確診COVID-19婦人於疫病門診之護理經驗

本文描述一位嚴重特殊傳染性肺炎確診婦人，面臨確診時與隔離治療後居家自主健康管理期間之護理經驗。個案因酸痛就醫轉至疫病門診進行採檢，在等待報告時，由於心理恐慌加上案夫不諒解、大聲辱罵她而產生高度焦慮，遂引起筆者關注；於2021年6月3日至6月29日，透過疫病門診、視訊及電話訪談，以觀察、會談、病歷查閱等收集資料，發現個案對疾病不確定及擔心家人不諒解產生「焦慮」、缺乏採取適當防護而有「無效性健康維護能力」、隔離期間，社會輿論及經濟壓力引發對家人感到愧疚有「情境性低自尊」等健康問題。協助個案釐清疾病照護問題，緩解焦慮情緒並提升自我健康維護能力，減少負向情緒及降低對家人感到愧疚。希將此經驗與臨床護理人員分享。

關鍵字

嚴重特殊傳染性肺炎；自主健康管理；焦慮；無效性健康維護能力；情境性低自尊

並列摘要

This article describes the nursing care experience of a woman who was diagnosed with coronavirus disease-2019 (COVID-19), from time of diagnosis and during the period of self-health management at home after isolation. The case was transferred to the epidemic clinic for examination due to general malaise and discomfort. While waiting for the report, she was highly anxious due to the psychological panic and the husband's incomprehension and loud rebuke to her, which aroused the author's attention. During the nursing period from 3rd to June 29th, 2021, the author collected data through observation, listening, face-to-face interviews, and medical history review through epidemic clinic, computer outpatient video and telephone interviews, focusing on evaluation of the physical, psychological and social aspects. While waiting for diagnosis, the case developed "anxiety" due to uncertainty about the COVID-19 and fear of family members' incomprehension, lack of awareness of the disease to take appropriate protections, resulting in "ineffective health maintenance ability", and after the quarantine period, the family members, social speech and economic pressure triggered feelings of guilt towards family members and produced "contextual low self-esteem". A care team was formed by physicians, infection control nurses, and epidemic outpatient nurses to track these health problems of individual cases and provide assistance during self-health management at home. The care team helped the patient clarify COVID-19 care, relieved her anxiety and improved the self-health maintenance ability while increasing her self-confidence, reducing the negative emotions caused by COVID-19 and reducing the feelings of guilt towards family members. Caring for COVID-19 cases is a rare experience, and the author hopes that this experience can be shared with clinical nurses as a reference for such cases.

並列關鍵字

coronavirus disease-2019 ； self-health management ； anxiety ； ineffective health maintenance ability ； contextual low self-esteem

參考文獻

王鳳葉(2021)．COVID-19感染預防和控制：居家照護防疫策略．呼吸治療，20(1)，81-88。https://doi.org/10.6269/JRT.2021 01_20(1).0010

李周燕、劉翎玲、廖嘉宏、洪弘昌、凌正華、李雅琴、葉麗月、洪世昌(2021)．照顧一位新冠肺炎感染者在隔離期間之護理經驗．弘光學報，(87) ，1-15。https://doi.org/10.6615/HAR. 202103_ (87).0001

許藏菁、吳佳鉛、賴霈妤、薛伶珊、賴怡因、柯乃熒(2020)．照顧一位COVID-19病人在隔離期間之護理經驗．護理雜誌，67(3)， 111-119。https://doi.org/10.6224/JN.202006_ 67(3).15

黃萬翠、陳瑛瑛(2020)．COVID-19（武漢肺炎)防疫戰-成功守住台灣之關鍵．護理雜誌，67(3)，75-83。https://doi.org/10.6224/ JN.202006_67(3).10

鄭家馨、李麗君、李慧琦(2022)．嚴重特殊傳染性肺炎：新冠肺炎之居家照護．若瑟醫護雜誌，39 (1)，18-29 。https://doi.org/10.6692/KJN.202204_39(1).0002

主題瀏覽