- 期刊
嚴重特殊傳染性肺炎重症病人復原期之照護經驗
Post-Acute Care for a Severe COVID-19 Survivor in the Recovery Phase
摘要
本篇探討嚴重特殊傳染性肺炎個案於復原期之護理經驗。個案因呼吸衰竭接受氣管插管及呼吸器支持並於加護病房觀察，拔管後轉入防疫病房負壓隔離病室持續照護。呼吸衰竭導致身體功能下降，加上疾病的不可預知性及外界對傳染性疾病的負面觀感等因素，皆加劇個案的焦慮感，影響其身心調適，引發選案動機。於2020年4月6日至4月20日期間，藉由會談、觀察、身體評估確立健康問題包括：因感染新型冠狀病毒導致肺部炎症，而有「感染」及「低效性呼吸型態」問題，因呼吸衰竭引起「活動無耐力」，因擔心身體功能無法恢復並憂慮外界看法而出現「個人因應能力失調」之問題。透過共享決策概念，以病人為中心，納入感染科及胸腔科醫師、護理師、呼吸治療師及復健師，擬定治療計畫，運用各科專長，協助個案進行功能訓練，增進活動耐力，提升自我照顧能力，邁向康復。此外，建立良好護病關係，提供嚴重特殊傳染性肺炎相關衛教知識，定時主動以通訊設備聯繫關懷，減輕個案心理困擾。建議醫院建置學習平台，整合各醫院照護經驗，使護理師在面對不可預知的新興傳染性疾病時，能及時提供最佳的治療與照護。
並列摘要
We report our experience of providing post-acute care for a patient with severe COVID-19 who experienced acute respiratory distress syndrome and received tracheal intubation and mechanical ventilation support. After being successfully weaned off the ventilator, he was transferred to a negative-pressure room in the quarantine ward for continuous care from April 6 to April 20, 2020. COVID-19 pneumonia had caused breathing insufficiency and functional decline. Uncertain disease progression and the negative outlook of society toward individuals with COVID-19 aggravated his anxiety. We identified four health problems through a therapeutic interview and physical assessment: infection, ineffective breathing pattern, activity intolerance, and poor individual coping. With the objective of enhancing activity endurance to improve self-care ability, we assisted the patient in functional rehabilitation toward recovery. Furthermore, we provided health education to improve understanding of COVID-19 and proactively contacted him through phone to alleviate his psychological distress. Based on our experience, we recommend multicenter collaboration and establishing a sharing platform to integrate real-time nursing experience of quarantine care in case of unprecedented emerging infectious diseases.
延伸閱讀
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