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照護一位酒精性肝硬化病人之護理經驗

Experience of Caring for an Alcoholic Cirrhotic Liver

Abstracts


本文描述一位中年男性酗酒導致酒精性肝硬化,此次因腹水及嘔吐咖啡色液體入院,住院期間個案因酒精戒斷缺乏心理調適技巧及家庭支持系統,導致多次情緒失控,出現攻擊醫療同仁行為。於2021年1月27日至2021年2月4日護理期間,藉由五大層面之整體性評估,確認個案有「體液容積過量」、「因應能力失常」及「家庭運作失常」三項主要健康問題,藉由增進活動、飲食衛教、監測攝入排出量等措施以改善生理症狀。透過放鬆技巧、參與宗教活動及辦理病房歌唱分享會方式協助病人紓壓,建立個人因應技巧。最後透過建立信任感,與案兄溝通使案兄願意陪同參與個案戒酒計畫,增進個案戒酒動力並達到心理支持,期盼此次照護經驗,能提供護理同仁日後照護相似個案之參考。

Parallel abstracts


The present case describes a middle-aged male patient with alcoholic cirrhosis from alcohol abuse. The patient was admitted to the hospital for his ascites and vomiting of coffee-colored liquid. The patient experienced alcohol withdrawal syndrome and because of a lack of psychological adjustment skills and a family support system, caused several incidences of emotional outbursts and aggressive behaviors toward the medical staff. From January 27, 2021 to February 4, data was collected through five levels of holistic care assessment and three major health problems were identified: fluid overload, ineffective coping and family dysfunction. Measures such as incased physical activity, dietary education and close monitoring of the intake and output amount were taken to maintain fluid balance and improve physiological symptoms. Relaxation techniques, participation in religious activities and singing sessions in the ward helped the patient to relieve stress and develop personal coping techniques. Through the establishment of trust and after communicating and discussing with the patient's brother, he was willing to accompany the patient to the sobriety program. This enhanced the patient's motivation and strengthened psychological support. We hope that the experience presented serves as a reference to other nursing staff when encountering similar cases in the future.

References


官喬琪、孫慧芳、潘雪幸(2022)。家庭凝聚力之概念分析。長庚護理,33(2),29-37。https://doi.org/10.6386/cgn.202206_33(2) .0003
郭彥君、張尚智、張馨予、許中華(2018)。中西醫結合治療酒精使用疾患文獻探討。中醫內科醫學雜誌,16(2),10-25。https://doi.org/10.7102/JTCIM.201812_16(2).0002
陳鏡華、李曉惠(2021)。從「情境犯罪預防」論醫療暴力。台灣醫學,25(3),403-410。https://doi.org/10.6320/fjm.202105_25(3).00 13
陳冠樺(2022)。酒精成癮者維持戒癮之影響因子研究。藥物濫用防治,7(1),27-53。https://doi.org/10.6645/jsar.202206_7(1) .2
Cioarca-Nedelcu, R., Atanasiu, V., & Stoian, I. (2021). Alcoholic liver disease-from steatosis to cirrhosis-a biochemistry approach. Journal of Medicine and Life, 14(5), 594-599. https://doi.org/10.25122/jml-2021-0081

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