協助一位罹患肺結核之愛滋病人規則就醫及服藥之照護經驗

The Nursing Experience of Caring for an AIDS Patient to Improve Medical Compliance and Regular Follow-up

林佳儀(Chia-Yi Lin) ； 潘玫燕(Mei-yan Pan) ； 劉秀雲(Hsiu-Yun Liu)

《臺大護理雜誌》 14卷2期 (2018/07) Pp. 121-133

https://doi.org/10.6740/NTUHJN.201807_14(2).0012

摘要

本文描述照護一位感染愛滋病毒後長期未規則追蹤、又罹患肺結核之個案，經護理師及支持系統介入，願意規則服藥之護理經驗；護理期間為2017年1月10日至2月03日，運用Gordon 11項功能性健康型態評估以進行資料收集與分析，確立個案的健康問題為：感染、個人無效處理治療計畫、焦慮等健康問題。護理過程中給予適當感染照護措施、愛滋病及肺結核相關觀念及衛教等，達成舒緩個案身心不適及感染改善的目標；又提供愛滋病相關護理指導、治療及可運用的資源，請病友分享服藥及就醫經驗，以增進健康認知，願意規則服藥及門診追蹤；最後以不批判態度、主動傾聽及鼓勵個案說出內心感受，並緩解個案的焦慮。愛滋病若遵從規則服藥及就醫可降低伺機性感染、增進生活品質，但許多愛滋個案因未遵從服藥及就醫，導致反覆入院及出現抗藥性，最後因伺機性感染厲害而致死亡，故建議臨床護理師透過建立良好的護病關係，給予個案愛滋病相關護理指導及支持系統的介入，以增進個案服藥及就醫之遵從性。

關鍵字

愛滋病 ； 肺結核 ； 服藥遵從性

並列摘要

The article describes the case of a patient who was infected with HIV, then failed to follow-up. He suffered from tuberculosis. Through the nursing care and supportive system, he agreed to take medicine and regularly follow-up. The care period was from 10^(th) January to 3^(rd) February 2017. According to the Gordon's 11-item functional health assessment, the health problems of this case included infection, ineffective management of the therapeutic regimen, and anxiety. Care included applying the infection control intervention and giving AIDS and TB's knowledge to improve the patient's health as well as providing education, medical information, and related resources. Finally, we let the patient receive medical and nursing advice to accept the compliance, listened to and encouraged the patient to speak out, and relieved their anxiety. Thus, the patient could reduce the risk of opportunistic infection and improve their quality of life. Many AIDS patients do not follow-up on medical advice, resulting in repeated hospitalization, medicine resistance, and even death. Improving the patient's medication and medical compliance by establishing a good care relationship and giving the patient AIDS-related health education and a supportive system are important.

並列關鍵字

AIDS ； TB ； Compliance