照顧一位因肥胖引起睡眠呼吸中止症個案之護理經驗

Nursing experience of a patient with obesity associated obstructive sleep apnea syndrome

張郁涵(Yu-Han Chang) ； 林錦穗(Chin-Sui Lin) ； 吳曉芬(Siao-Fen Wu)

《彰化護理》 24卷3期 (2017/09) Pp. 73-84

https://doi.org/10.6647/CN.24.03.11

摘要

本文是描述一位因重度肥胖導致阻塞性睡眠呼吸中止症（obstructive sleep apnea syndrome, OSAS）病人的照護經驗。護理期間自2014年2月24日2014年至3月6日，筆者運用Gordon十一項健康功能型態評估工具，透過觀察、會談、傾聽與身體評估等方法蒐集資料，確立個案有活動無耐力、營養不均衡：多於身體需求、焦慮等健康問題。護理過程中筆者提供個別性措施，協助個案渡過急性期生理、心理上的危機，教導個案採漸進式的有氧運動計量來增加運動耐受力進而減輕呼吸喘之症狀；告知減輕體重的重要性，並加強飲食控制及運動的指導，使體重減輕後有效的減少慢性病及OSAS的發生。個案常因害怕睡覺時呼吸突然停止而死亡，進而產生焦慮的情形，在照護過程中，筆者鼓勵個案表達內心感受，以同理心、關懷並主動傾聽個案想法，期望家人親自陪伴，以減輕個案住院期間所產生的焦慮狀態，適時滿足身體舒適與安全需求，使個案儘早恢復日常活動功能及減輕危險因素，減少OSAS的再發生率。期望藉由此篇報告之護理經驗，能提供臨床護理人員日後照護相關病人之參考。

關鍵字

肥胖 ； 睡眠呼吸中止症 ； 護理經驗

並列摘要

This article describes the nursing experience of a patient with severe obesity associated obstructive sleep apnea syndrome (OSAS) during the period from 24th February to 6th March in 2014. Based on observations , interviews, attentive listening, physical evaluation and Gordon's 11 Functional Health Patterns Assessment, the author identified that the patient suffered from activity intolerance, imbalanced nutrition more than body requirements and anxiety. During the nursing process, the author provided individualized nursing care to help the patient overcome acute mental and physical disorders, combined with progressive aerobic exercise plan to increase exercise endurance and reduce shortness of breath. The patient was informed about the importance of weight control and under strengthened guidance of diet control and exercise, which effectively enabled the patient to lose weight and relieve the symptoms of OSAS and chronic diseases. In order to ease the patient's anxiety caused by hospitalization and from the fear of dying in sleep due to OSAS, the author showed sympathy, caring attitude and active listening while encouraging family companion and the patient to express feelings to offer physical comfort and meet the patient's safety needs, which helped the patient restore daily activity functions, prevent risk factors and reduce the relapse of OSAS. This nursing experience may provide clinical reference m caring for such cases in the future.

並列關鍵字

Obesity ； obstructive sleep apnea syndrome(OSAS) ； Nursing Experience

參考文獻

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