本文描述一位罹患格林-巴利症候群(Guillain-Barré Syndrome)患者,因肌肉無力導致缺乏自我照顧能力,於加護病房入住期間對環境、治療等感到陌生、害怕,而出現無望感以及死亡等意念。護理期間為2016年12月28日至2017年1月4日,經由直接照護、傾聽、觀察、會談、身體評估等方式蒐集資料,並使用Gordon十一項健康功能型態評估表分析出個案主要健康問題為:低效性呼吸型態、身體活動功能障礙、無望感。筆者透過護病關係的建立,教導個案增強呼吸肌肉的重要性以及相關措施,以改善個案通氣狀態;採血漿置換術的方式,改善肌肉無力症狀;藉由主動關懷、陪伴以及家庭支持系統,引導個案主動表達心中的感受,並透過個別性護理,設計個案活動能力評量表,將每天的活動能力數字化,增加個案的信心、對治療有正向的態度、願意參與照顧活動,重新找回自己生命的意義。
This article describes an experience from caring of a patient with Guillain - Barré Syndrome whose muscle weakness caused dysfunction of self -caring. The nursing care period lasted from December 28, 2016 t o January 4, 2017. The data were collected through observing patient, interviewing and physical assessment. While applying the Gordon's 11-Functional Health Patterns assessment tool, the following problems were identified: inefficient breathing pattern, impaired physical mobility, and hopelessness. The author built up a good therapeutic relationship with the patient, through plasma exchange to improve muscle power over the limbs; providing active care, companionship, and family support systems to guide the patient in this case to express inner feelings and needs. As well as independent nursing care, designated personal activity capacity assessment, improving confidence of the patient in this case, enhancing a positive attitude towards treatment, actively cooperate with the treatment plan, and therefore restored meaning in her life.