- 期刊
照顧一位法洛氏四合症併無肛症嬰兒及其家庭之護理經驗
Nursing Care Experiences of a Family with Children with Tetralogy of the Fallot and Congenital Imperforate Anus
摘要
本文旨在探討一位罹患法洛氏四合症（Tetralogy of the Fallot, TOF）併無肛症之嬰兒的護理經驗。自2018年2月25日至5月10日期間，運用身體評估、觀察、溝通會談、直接照顧的方式，發現個案主要有呼吸道清除功能失效、營養少於身體所需、照顧者角色緊張、家庭運作過程紊亂等健康問題。個案在出生六個月內共經歷三次心臟與人工造口手術，面對孩子複雜的病情，案母承受照顧的責任與學習多項技術的壓力；尤其目睹兩次緊急急救後，案母對於學習居家照顧的過程中表現出焦慮緊張、沒有信心。護理師以關懷的溝通方式，與家屬建立信任感，運用家庭為中心的護理概念了解家庭與醫療共同確定的治療目標，讓案父母可以決定他們參與照顧個案的目標，並整合跨團隊照護資源共同擬訂居家準備照護計畫。最終個案順利移除呼吸器，體重逐漸穩定成長，成功轉出加護病房，案母也開始對返家照顧個案表示期待，有信心擔任照顧者的角色。希望藉由此個別化護理之呈現以及協助其父母家庭因應過程，做為臨床護理同仁之參考。
並列摘要
This article described a nursing experience of an infant with Tetralogy of the Fallot with imperforate anus. The nursing care period was from February 25, to May 10, 2018. Data were collected by systematic physical examination, practical clinical care and interviews, which revealed four major problems: (1) ineffective airway clearance; (2) imbalanced nutrition below bodily requirements; (3) caregiver role strain; (4) interrupted family processes. The patient underwent surgery three times and cardiopulmonary resuscitation twice. His mother was anxious, nervous and not confident due to his condition. Due to heart disease, the patient was not successfully weaned off the ventilator and experienced nutrient deficiency. The author used family-centered care and caring communication to build a sense of trust with the parent, while integrating cross-team resources to implement the appropriate care plan, improve quality of care, and help the mother learn the skills necessary for this patient. After weaning off the ventilator, the patient weight grew steadily, was successfully transferred out of the intensive care unit, and his mother became much more positive and confident. This case study provides a reference for clinical and individualized nursing.