- 期刊
運用自我管理概念於一位心衰竭併發肺水腫病人之照護經驗
Nursing Care Experience of Self-management Implementation in a Heart Failure Patient with Pulmonary Edema
摘要
本文在探討一位中年獨居個案因心衰竭併發肺水腫入院治療之護理經驗，照護期間為2018年2月27日至2018年3月23日，照護過程運用身體評估、觀察、會談、傾聽和跨團隊討論來收集資料，並以自我管理概念合併生、心、靈及社會層面的護理問題評估，確立個案有心輸出量減少、營養需求少於身體所需及焦慮等護理問題。筆者透過心衰竭自我管理概念的運用，教導個案辨識心衰竭節症狀、落實病人藥物指導、低鈉飲食、水份控制及心衰竭日常照護注意事項，以降低因心衰竭呼吸喘反覆入院治療；建議少量多餐進食方式及學習蔬果調味烹煮方式，以增加熱量攝取量；連結長照計畫2.0資源，解決出院後擔心長期需氧氣供應的經濟支出，降低其焦慮感；增強醫療團隊與教友支持系統，以彌補個案缺乏家庭支持的遺憾，希望藉此照護經驗分享，提供類似個案之照護參考。
並列摘要
This article describes the nursing care experience of a middle-aged patient who lived alone and suffered from heart failure with pulmonary edema. During the nursing period between February 27 and March 23 in 2018, observations, interviews, conversations, and physical assessment skills were used to gather information and assess the patient in five aspects, including physical, emotional, intellectual, social, and spiritual well-being. In particular, the heart failure related self-management concept was applied to identified potential and existing major health problems, including: decreased cardiac output, imbalanced nutrition: less than body requirements, and anxiety. Individual nursing care plan was designed and tailored to address heart symptoms, diets, and long-term care to improve heart failure outcomes. Self-management implementation has incorporated teachings to assist self-identifications of heart failure symptoms and adherence to regiments of medications, appropriate diet plans, and adequate water intake. Nursing care provided not only has increased self-management skills but also strengthened the patient's support system from medical team and church members to prevent further hospitalizations, decrease economic burdens, and link to government resources of long-term care plan 2.0. This experience would shed light to health care providers when caring for symptomatic health failure patients who lived alone with little family and social support.