照護一位酒精性肝硬化病人之護理經驗

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。

關鍵字

酒精性肝硬化；醫療暴力；因應能力失常；家庭運作失常；心理調適技巧

並列摘要

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.

並列關鍵字

alcoholic cirrhosis ； medical violence ； dysfunction in response to ability ； dysfunction in family functioning ； psychological coping skills

參考文獻

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