照顧一位心肌梗塞個案之門診護理經驗

The Experience of Out-Patient Department Nursing Care About a Case of Myocardial Infarction

鄭雅婷(Ya-Ting Cheng) ； 孫懷德(Huai-De Sun) ； 白玉玲(Yu-Ling Bai)

《華醫學報》 49期 (2018/12) Pp. 78-92

摘要

本文旨在探討一位經歷心肌梗塞初次發作的個案，於門診接受衛教指導增加自我照顧能力之護理經驗。照護期間自2014年10月27日至2015年1月18日，在六次回診中，透過觀察、訪談與病歷查證、電話追蹤等方式收集資料，以Gordon十一項健康功能模式評估，確立個案護理問題為低效性健康維護能力、靜態生活型態與焦慮。在低效性健康維護能力方面，提供心肌梗塞疾病相關照護概念，調整生活型態及控制危險因子；在靜態生活型態上，加強個案運動的知識及動機，教導執行心臟復健，提高其活動功能。另以關懷支持增強個案對疾病控制感，並緩解其焦慮。期望藉此護理經驗之分享，做為未來門診照護心肌梗塞個案的參考。

關鍵字

心肌梗塞 ； 門診 ； 焦慮 ； 低效性健康維護能力改變

並列摘要

The following paper investigated a specific case of an individual experienced a new type of onset myocardial infarction. Additionally, this work illustrated how the patient elevated the self-care ability of nursing experience during the outpatient-department instructions. During the caring period, we confirmed that the case nursing problems included ineffective health maintaining ability, sedentary lifestyle and anxiety. These problems were displayed through the six visits to the clinic, the interviews and the verification of charts, the follow up telephone calls to collect data and the use of Gordon 11-item Functional Health Pattern Assessment. The ineffective health maintaining ability can be addressed by providing the care information of myocardial infarction disease, adjusting the lifestyle and controlling the risk factors. To improve activity function in patients' static lifestyle, enhancing patients' knowledge and motive of exercise, and instructing patients how to do cardiac rehabilitation by themselves. Providing care, support and individual patient education has the potential to increase self-sense of disease control and to relieve anxiety. We expect that sharing the nursing experience can be used as a reference in order to ascertain out-patient clinic care in the future.

並列關鍵字

myocardial infarction ； outpatient department ； anxiety ； ineffective health maintaining ability