急性嚴重呼吸道症候群病患之護理經驗

Nursing Experience in a Case of SARS

曾玉卿(Yu-Ching Tseng) ； 蔡明足(Ming-Tsu Tsai) ； 黃素珍(Su-Chen Huang)

《北市醫學雜誌》 5卷1期 (2008/02) Pp. 146-151

https://doi.org/10.6200/TCMJ.2008.5.1.16

摘要

目的：本文旨在描述一位臨床護理人員因照顧病人罹患嚴重急性呼吸道症候群住院之護理經驗。方法：以羅氏適應模式為評估架構，採陪伴、傾聽、觀察、雙向溝通方式蒐集資料。結果：本研究發現個案有低效性呼吸型態、焦慮、睡眠障礙等問題。經密切觀察生命徵象、評估週邊動脈氧氣濃度及呼吸肌使用情況，氧氣使用並教導橫膈呼吸與使用有效咳嗽方法；即時提供病程進展之正向資訊、同儕復原及家人健康情況，並建立同儕支持網絡，鼓勵說出對於罹病的感受以減少負面情緒反應。結論：本研究協助病患改善環境中的壓力源等護理措施介入後，結果使個案能回復正常且平順呼吸；克服對死亡的恐懼而降低焦慮，更表達出繼續返回職場為病患服務的意願；同時達成夜間4~5小時無間斷的睡眠品質。

關鍵字

SARS ； 死亡恐懼 ； 焦慮

並列摘要

Background and Purpose: This article describes a clinical nurse's experience of acquiring SARS while caring for SARS patients. Methods: The study used Roy's adaptation model to assess the nurse clinical condition, and data collected thru accompanying, listening, closely observing and communicating with her. Results: The study observed that our case had the following problems: low effective breathing patterns, anxiety and sleep disturbance. With close observation, monitoring of vital signs, ABG (arterial blood gas) and the uses of accessory respiratory muscles, we supplemented her with O2 and instructed her regarding the proper ways of breathing and the effective coughing method. We updated her clinical condition and provided positive information regarding the disease, informed her of the recovery condition of other nurses and her family’ s health condition, showed support from others and encouraged her to discuss her disease and fear to minimize any negative emotions. Conclusion: With proper nursing care, our case was able to face environmental stress and gradually regained a smooth breathing pattern; she was able to face her fear of dying, which decreased her anxiety and promoted quality sleep. She even expressed a desire of returning to work and to care for patients.

並列關鍵字

SARS ； fear of dying ； anxiety