運用心臟復健照顧一位心肌梗塞病人之護理經驗

The Nursing Experience of Providing Cardiac Rehabilitation Care for a Myocardial Infarction Patient

徐愬美(Suh-Meei Hsu)

《馬偕護理雜誌》 11卷1期 (2017/01) Pp. 103-113

https://doi.org/10.29415/JMKN.201701_11(1).0009

摘要

本文為運用心臟復健照護一位心肌梗塞病人之護理經驗，此個案為初次罹患急性心肌梗塞，因對疾病進展感到憂心，出現活動無耐力、焦慮及對疾病知識不足。護理期間自2015年5月5日至5月9日。以Gordon十一項功能性健康型態為評估工具，經觀察、會談、身體評估等方式，收集生理、心理、社會及靈性各層面資料，確立個案的主要問題有「活動無耐力」、「焦慮」、「健康維護能力改變」等健康問題。護理過程中，有計畫的執行心臟復健活動，配合飲食及藥物治療，以漸進式方式增進個案心肺功能；用主動關懷及同理的態度，緩解焦慮，並提供個別性的護理指導及疾病相關知識，病人出院時心臟復健活動可達3.5METs，並主訴焦慮感獲得減輕，也瞭解如何自我照顧之方法。建議針對此類患者應常規照會復健科，提供病人心臟復健服務，並設立「心臟病個管師」，以提升照護品質。期望藉此護理經驗，提供臨床護理人員照護之參考。

關鍵字

心肌梗塞 ； 活動無耐力 ； 心臟復健

並列摘要

The purpose of the article is nursing experience of cardiac rehabilitation after myocardial infarction. Because the patient got the myocardial infarction for the first time, he lacked knowledge about the disease. He was in anxiety status and worried about the prognosis of the disease. The duration of nursing care is from May 5th. 2015 to May. 9th. 2015. The clinical data was collected and assessed by observation, interview, and physical examination according to the holistic nursing assessment including physiological, psychological, social and spiritual dimensions. The patient's health problems included activity intolerance, anxiety and ineffective health maintenance. To improve cardiopulmonary function, we provided optimal medical therapy and adequate diet control. The nursing care included proactive care with empathy and individualized healthy education. After discharge, the patient's activity was improved to 3.5 METs and anxiety was relieved, he also knew how to do self-care. We always consulted rehabilitation specialist for patients with myocardial infarction. In addition, a cardiology case manager can play an important role in post myocardial infarction care. This nursing care experience can be a guide to other clinical nursing staff.

並列關鍵字

cardiac rehabilitation ； myocardial Infarction ； activity intolerance