- 期刊
運用個別化發展性照護一位心肌炎新生兒護理經驗
The Nursing Experience of Applying the Newborn Individualized Developmental Care and Assessment Program on a Newborn patient with Myocarditis
摘要
本文是描述運用新生兒個別化發展性照護方案於一位出生第6天出現心肌炎個案及其照顧者之護理經驗。案父母因新冠肺炎流行期間有旅遊史及接觸史無法親自前來探視，面對個案病情變化產生極大的壓力與衝擊。2020/3/30至2020/4/20照護期間以五大層面評估，確立健康問題有低效性呼吸型態、心輸出量減少、混亂性嬰兒行為及親子依附關係障礙。在護理過程中，透過減少耗氧量及監測輸入量與排出量的平衡等措施，提升氣體交換功能；同時提供療癒性環境、使用輔助物擺位，減少嬰兒之壓力與疼痛反應，以促進安穩睡眠；案父母方面，建立友善的護病關係、安排視訊會客、主動提供相關疾病發展及治療狀況、傾聽並鼓勵表達壓力、關心案母健康、鼓勵餵食母乳，以降低焦慮重建親子關係．希望此護理經驗能提供臨床醫護人員作為照護參考。
並列摘要
This article describes the nursing experience of a case of myocarditis on the 6th day after birth and the newborn's caregiver by using an individualized developmental care program for neonates. The parents were unable to visit in person owing to their travel and contact history during the coronavirus disease pandemic (COVID-19), resulting in great pressure and impact in the face of the changes in the patient's condition. The nursing period was from 2020/3/30 to 2020/4/20, and comprehensive nursing assessments were used to establish health problems such as ineffective breathing patterns, decreased cardiac output, disorganized infant behavior, and impaired parent-child attachment relationship. During the nursing process, the author improved gaseous exchange function by reducing oxygen consumption and monitoring the balance of input and output while concurrently providing a healing environment, using auxiliary objects to position and reduce the response to stress and pain. Sleep stability was also promoted, and for the parents of the case, a friendly nurse-patient relationship was established through arranging video conferences, proactively providing information on the development and treatment of related diseases, being attentive to and encouraging the expression of stress, caring about the mother's health and encouraging breastfeeding, so as to reduce anxiety and rebuild the parent-child relationship. It is indeed anticipated that this nursing experience can be referred to by clinical and medical staff under suitable and relevant circumstances.