初確診愛滋病毒感染之照護經驗－個案報告

Care of a Newly-diagnosed HIV Positive Patient: A Case Report

游淑敏(Shu-Min Yu) ； 劉陳愛勤(Ai-Chin Liu Chen) ； 黃露秋(Lu-Chiu Huang) ； 李金霙(Chin-Ying Li)

《北市醫學雜誌》 14卷3期 (2017/09) Pp. 379-390

https://doi.org/10.6200/TCMJ.2017.14.3.13

摘要

本篇是描述一位30歲男同志，在此次檢查下發現自罹患愛滋病，產生情緒低潮、無望感及焦慮之疾病適應護過程。護理期間自2014/12/02至12/17及出院後電話訪問2次。運用Gordon十一項功能性健康評估為評估架構，藉由身體評估、觀察、密閉式會談等方式收集資料，確立個案有焦慮對愛滋病認知不足及對未來的不確定感及擔心人際關係疏離有關、腹瀉與感染阿米巴腸炎有關、無望感與得知愛滋病帶原，對未來有負面想法有關。護理過程中建立治療性及信任護病關係，透過持續性關心，鼓勵表達內心感受，與社工師共同關心及提供社會資源，適時情緒支持以降低焦慮，在尊重與維護病人隱私下，維持良好互動並尋求家人的支持，運用護理指導單張及手冊教導，以增進病人對疾病認知，並適時提供有關疾病的傳染途徑及防護措施，使其重拾信心轉正向的調適技巧，使病人最後順利回歸家庭生活與工作職場，協助病人達到身、心、社會適應。

關鍵字

愛滋病 ； 阿米巴腸炎 ； 無望感

並列摘要

This report describes the nursing experience of a 30-year-old homosexual male who experienced depression, desperate and anxiety status and his adaptation process to the positive result of HIV test. The nursing period was from 2 Dec to 17 Dec 2014. The patient was also interviewed by telephone twice after discharge. The Grodon 11 functional health pattern assessment was used as assessment framework, and data of the patient were collected by physical evaluation, observation and closed interview. We analyzed and concluded several main problems of the patient, including (1) anxiety related to knowledge deficiency on AIDS, uncertainty in future and alienation of human relationship, (2) diarrhea related to Amoeba colitis infection, and (3) negative thoughts related to hopeless and positive result as a HIV carrier. During the nursing period, we first established a trustable patient-medical staff relationship. Through persistent care and encouragement to express patient’s feelings and with additional help from social workers and social resources, we provided emotional support opportunely to release his anxiety. With respect and protection of privacy of the patient, we communicated with the patient smoothly and sought his family support. We used guideline sheet and booklet to improve patient’s understandings of the disease; we educated the patient on the topics of disease transmission route and protection measures and adaptation skills to regain confidence, so that he could return to normal family life and workplace, and adapted physically, mentally and socially.

並列關鍵字

AIDS ； Amoeba colitis ； hopeless