照顧一位Guillain-Barr'e症候群年輕女性之護理經驗

本文探討一位27歲年輕女性因罹患Guillain-Barr'e症候群致下肢無力、刺痛進而使活動功能下降，擔憂治療方式與成效而產生焦慮之護理經驗。護理期間為2019年11月26日至12月18日，藉由身體評估、會談、傾聽與觀察法收集資料，以Gordon十一項健康功能型態評估，確立個案主要健康問題有急性疼痛、身體活動功能障礙及焦慮等。透過會談及醫病共享決策之方式引導面對焦慮來源，增加自我控制感，協同跨團隊治療及擬定復健運動計畫，照護過程中以藥物及非藥物治療方式改善疼痛，使能以正向的態度配合復健，提升自我照顧能力並即早回歸家庭和社會。受限於疾病進展快速，資訊來源不足及對治療方式的猶豫，建議可增加醫病共享決策輔助表，以認識疾病並釐清治療方針，討論後共同決定治療方式，增加治療參與度及信心。疾病導致的活動功能障礙，需長時間復健，建議可將神經肌肉疾病納為急性後期照護計畫之收案範圍，給予積極之整合照護，使其恢復自我照顧功能，期望透過此護理經驗，作為日後護理照護之參考。

關鍵字

Guillain-Barr'e症候群；身體活動功能障礙；急性疼痛；焦慮；醫病共享決策

並列摘要

This article discussed the nursing experience of a 27-year-old young woman suffering from Guillain-Barré syndrome, causing weakness and tingling of the lower limbs, which in turn led to decreased mobility, and concerns about treatment methods and effectiveness. The nursing period was from November 26 to December 18, 2019. Through physical assessment, interviews, listening and observation methods, collecting data, using Gordon 11 Function Health Patterns as a guide, the main health problems of the case were acute pain, physical activity dysfunction and anxiety, etc. The methods included leading the patient to face the source of anxiety through discussion and shared decision-making between doctors and patients, increasing the sense of self-control, coordinate cross-team therapy and formulate rehabilitation exercise plans, and using drugs and non-drug treatments to reduce pain during the care process, having positive attitude toward rehabilitation, improving self-care ability and return to family and society as soon as possible. Limited by rapid disease progression, insufficient information sources, and hesitation on treatment methods, it is recommended to add the shared decision-making support table for doctors and patients to understand the disease and clarify the treatment strategy. After discussion, the treatment method can be jointly decided to increase treatment participation and confidence. Movement dysfunction caused by disease requires long-term rehabilitation. It is recommended that neuromuscular diseases be included in the scope of the acute post-care plan, and active integrated care should be given to restore self-care functions. Hope that this nursing experience can be used as a reference for future nursing care.

並列關鍵字

Guillain-Barré syndrome ； physical activity dysfunction ； acute pain ； anxiety ； shared decision-making

參考文獻

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照顧一位Guillain-Barr'e症候群年輕女性之護理經驗

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