- 期刊
一位肝性腹水反覆入院病患面對無力感之照護經驗
The Care-giving Experience for a Repeatedly Hospitalized Hepatic Ascites Patient with a Sense of Powerlessness
摘要
本文探討一位47歲男性，因為肝性腹水與感染反覆入院，產生無力感的護理經驗。個案自2014年至2015年間因為肝硬化及其合併症共計住院四次，於2015年6月1日再次因為肝性腹水併發感染而入院治療，筆者於2015年6月1日至6月25日照護期間，運用Gordon十一項健康功能評估，採觀察、會談、身體評估及實際照護等方式進行資料收集，確立個案有體液容積過量、體溫過高、營養不均衡：低於身體所需、無力感四項主要健康問題，藉由專業知識與個別性的護理措施，滿足生、心理之照護需求。生理層面密切監測輸入與排出量，教導個案低鈉飲食的攝取方法，衛教適度休息的重要性，維持體液的平衡，同時監測體溫變化，運用促進散熱的方法改善發燒的情形，增進舒適感，與病患、家屬及營養師共同擬定飲食計畫，兼顧個案食慾與營養狀況，建立足夠的營養支持，以因應疾病的挑戰。心理層面運用同理心、傾聽及溝通等技巧，了解個案的無力感情形，鼓勵正向面對疾病，增強自我照顧的技能，使其恢復自信，克服無力感，最終使個案勇於面對疾病過程，度過此次生命的考驗。
並列摘要
This patient of this article is a 47-year-old male suffering from hepatic ascites and infection with repeated hospitalization. The aim of this paper is to describe the experience of providing care for a patient with powerlessness. This patient has suffered from hepatic ascites in combination with infection and was thus hospitalized for treatment. The author provided caregiving methods by following Gordon 11 function health patterns analysis, including observation, interview, physical examination, and actual care giving for collect data during the period of June 1 to June 25, 2016. These data were collected to ensure whether this individual had fluid volume excess, fever, malnutrition and powerlessness the four main health factors that are carefully considered. Professional knowledge and individual characteristics were considered in nursing methodology to further satisfy the patient's physical and mental needs. On the physiological level, input and output were monitered closely. The patient learned the intake of a low sodium diet; patient instruction emphasized the importance of moderate rest, and maintained body fluid balance. Simultaneously, the care included monitoring temperature changes, using the dissipate heat method to improve fever. All the above efforts are made to improve the patient's comfort. Working with the patient, his family, and nutritionist, we proposed a dietary scheme to ensure that both cravings and nutritional values were considered, thus establishing proper nutritional support to fight the disease. On the psychological level, listening, and communication skills were utilized to understand the patient's powerlessness, with positive encouragement to combat the disease for ultimately restore confidence and overcome the powerlessness.