初診斷愛滋病毒感染個案之護理經驗－個案報告

Nursing Experience for a Newly Diagnosed HIV Case: A Case Report

顏岑芳(Tsen-Fang Yen) ； 郭俐蘭(Li -Lan Kuo)

《北市醫學雜誌》 17卷3期 (2020/09) Pp. 343-353

https://doi.org/10.6200/TCMJ.202009_17(3).0009

摘要

個案為30歲男性，於初診斷愛滋病毒感染時，因缺乏疾病正確認知與擔心發病，引發失眠、焦慮、害怕死亡等負向情緒及行為。護理期間自2017年8月26日至2017年12月12日止，運用Gordon十一項健康功能型態評估，確立個案有無效性健康維護能力、焦慮、睡眠型態紊亂等健康問題。透過疾病討論與跨領域團隊照護，增加疾病認知與治療意願；協助心理調適、主動關懷同理個案、強化家屬支持，增進治療信心；協助察覺影響睡眠因素，教導改善睡眠品質、增進舒適度。透過共同決策分享，由醫、護、心理師與個案及家屬召開溝通會談，指導正向思考、積極治療，維持健康生活模式，除改善個案健康問題外，更幫助全家走出愛滋陰霾。

關鍵字

愛滋病 ； 無效性健康維護能力 ； 睡眠型態紊亂 ； 焦慮

並列摘要

We reported a 30-year-old male with newly diagnosed HIV in 2017. Due to his HIV phobia and a lack of disease knowledge, he suffered from prominent insomnia, anxiety, and negative emotions and behaviors, like extreme fear of death. During the nursing period from August 26, 2017 to December 12, 2017, we performed a holistic approach through the use of Gordon's eleven health functional assessments. Health problems of futile health maintenance ability, anxiety, and sleep pattern disturbance were noted. Through the discussion and multidisciplinary care, we enhanced his understansing of the disease and intention to treat; we assisted his psychological adjustment, showed active solicitude and empathy, helped strengthen family support, and enhanced his confidence on the treatment; we helped him to identify factors that affected sleep, improved sleep quality, and increased sleep comfortability. A shared decision making process involving phycisians, nurses, psychologists, patient, and his family was performed to form a positive thinking, active treatment, and maintain health life model. Besides from improving patient's health, this helped the whole family to walk away from the haze of AIDS.

並列關鍵字

HIV ； futile health maintaining ability ； sleep pattern disturbance ； anxiety