一位長期臥床失智症病人及其外籍看護工之護理經驗

A Nursing Experience for a Foreign Caregiver Facing a Dementia Patient with Bedridden Status

許郁姍(Yu-shan Hsu) ； 蕭佳莉(Chia-Li Hsiao) ； 陳淑芳(Shu-Fang Chen)

《高雄護理雜誌》 35卷1期 (2018/04) Pp. 104-115

https://doi.org/10.6692/KJN.201804_35(1).0009

摘要

本篇報告描述一位失智症病人，因疾病變化導致日常活動功能退化而長期臥床，病人產生合併症後造成外籍看護工照護上的困難及壓力，筆者藉由護理措施介入，減輕外籍看護工的壓力負荷之護理經驗。照護期間為2013/02/21至2013/02/29，透過身體檢查、觀察、會談、病歷查閱及出院返家後電話追蹤等方式收集資料，評估主要照護者壓力源，確立病人之健康問題有：（一）呼吸道清除功能失效；（二）尿路感染；（三）照護者角色緊張。在照護期間將外籍看護工之壓力及需求納入護理計畫。針對整體性護理照護，以護理措施、衛教及支持方式，衛教外籍看護工相關照護技巧，利用印尼文衛教單張，協助解說衛教內容，並配合討論及回覆示教，提供外籍看護工與病人相關疾病照護訊息，給予持續性關懷，運用同理心及傾聽等技巧建立信任關係，減輕照護者的照護負荷及壓力得到適當的緩解，並對居家照護知識獲得提升，讓病人得到完整的照護品質。藉此護理經驗，提供臨床護理師參考，讓此類病人順利返家並得到適切的照護。

關鍵字

失智症 ； 長期臥床病人 ； 外籍看護工

並列摘要

This report describes a dementia patient who had progressive disability and finally became bedridden. This deterioration of illness made the foreign (Indonesian female) caregiver become stressed and made it hard for her to take care of this patient. The authors shared their experience of a nursing process to improve the quality of care and reduce the stress of the caregiver. During the period from 21 Feb to 29 Feb 2013, the authors used several methods to collect data, including a physical examination, bedside observation, interview, medical review and phone-tracking mode after the patient was discharged from our hospital to continuously follow-up the patient and his caregiver. Besides, the authors used physical, psychological, and social dimensions to assess the patient and the caregiver. Finally, they established three major health problems: (I) ineffective airway clearance, (II) urinary tract infection and (III) stress of the caregiver. During the nursing process, not only for the medical management, the authors also took the stress of the caregiver into consideration. Based on holistic nursing, they provided nursing intervention, education and support in order to help the foreign caregiver care for the patient. The authors used Indonesian language educational documents to explain disease information and healthcare-related skills, encouraged discussion, and demonstrated how to care for the patient. In addition, they also used empathy and listening skills to establish a close relationship between the nurse and caregiver to promote the care quality. The above nursing process can reduce the care burden and relieve caregiving stress. Eventually, the knowledge of home care was carefully taught in order to continue high care quality at home. We wish to share our care experience as a reference to clinical nurses.

並列關鍵字

dementia ； long-term bedridden patient ； foreign caregiver

參考文獻

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