- 期刊
照護一位愛滋病病人伺機性肺部感染之加護護理經驗
Intensive care Nursing Experience of AIDS Patient with Opportunistic lung Infection
摘要
本文描述一位年輕男性初診斷愛滋病且併發伺機性感染，入住加護病房之護理經驗。病人除了面臨呼吸衰竭之生理不適，更需擔憂病情被曝露之心理壓力，而自我隔離、意志消沉，故選案介入照護。護理期間為2017年3月27日至4月3日，經由直接照護、身體評、紙筆溝通、觀察、會談、與家庭互動等方式收集資料，以Gordon十一項功能性健康型態評估，確立病人有「呼吸道清除功能失效」、「特定知識缺失」、「焦慮」等主要健康問題，護理期間先協助病人維持呼吸道通暢，再配合呼吸訓練脫離呼吸器，並建立信任的護病關係，不在公共區域討論病情以維護病人隱私與尊嚴，提供愛滋病醫療訊息與知識，降低其焦慮感，引導正向面對疾病，敞開心扉與家人互動，做重返職場之準備。礙於單位的疾病屬性，對於愛滋病病人的照護及病情告知之能力較欠缺，故建議單位規劃「愛滋病倫理照護議題」之教育訓練，提升單位的愛滋病加護照護能力，期望此護理經驗供愛滋病人照護之參考。
並列摘要
We present the intensive care unit nursing experience of a young male AIDS patient with complications of opportunistic lung infection. In addition to the physical discomfort of respiratory failure, the patient also experienced psychological stress from worrying about social exposure of his AIDS illness, which led to self-isolation and depression. The patient was therefore given interventional nursing. The nursing period was from March 27 to April 3, 2017. Data were collected through direct care, physical evaluation, pen-and-paper communication, observation, interviews, and interaction with family members. Gordon's 11 functional health patterns assessment was used as the tool for evaluation. The patient presented with major health problems such as ＂ineffective airway clearance,＂ as well as experiencing ＂insufficient AIDS-related knowledge, ＂ and ＂anxiety.＂ During the nursing period, the first priority was to maintain an open airway, and, following this, to wean the patient from the respirator by training him in breathing exercises, and then to build trust with the patient. Public discussion of the patient's condition was avoided to maintain patient privacy and dignity, and medical information and knowledge on AIDS were provided, which effectively reduced anxiety and stress. The patient was counseled in facing the disease with a positive attitude, interacting with family members with an open mind, and preparing to return to normal work. Due to the characteristics of the intensive care unit, the ability to fully care for and inform AIDS patients is insufficient. Therefore, we recommend that the unit plan specific education and training on ＂AIDS-related ethical care issues＂ to enhance the quality of AIDS intensive care. We expect our nursing experience to serve as a reference for the care of AIDS patients in the future.
延伸閱讀
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