照顧一位肌無力症合併胸腺瘤切除術後病患之護理經驗

The Nursing Experience for a Patient with Myasthenia Gravis and Thymoma Post Thymectomy

本文係探討一位罹患肌無力症(Myasthenia Gravis)病患，在行胸腺瘤切除術後進入加護病房照顧之護理經驗。筆者於2004年3月22日至3月30日照護期間，運用觀察及會談技巧收集資料，以Gordon十一項功能性健康型態進行整體性評估，發現病患主要健康問題有呼吸道清除功能失效、急性疼痛、潛在危險性感染、焦慮及知識缺失。護理過程中筆者經由良好護病關係的建立，針對病患需求提供個別性護理措施，協助面對身體、心理之健康問題，把握適當時機教導居家照護之注意事項，擬定返家後『每日作息計劃表』增強自我照顧之獨立性，並於鼓勵下病患加入肌無力俱樂部，與其它病友分享疾病過程，使身、心及社會獲得良好適應。期望此護理經驗對日後照顧此類個案之臨床護理同仁能有所助益。

This case report described the nursing experience of a patient with myasthenia gravis post thymectomy in the intensive care unit. During the caring period bewteen March 22 and 30 in 2004, information was collected through clinical observation and interviews. According to the eleven criteria of Gorden, health problems of this patient were identified as follows: ineffective airway clearance, acute pain, high risk for infection, anxiety, and knowledge deficit. After a good patient-nurse relationship has been established, individualized nursing intervention according to the patient needs was proposed to intensively deal with the physical and psychological discomfort of the patient and improve patient’s selfcare ability. This patient was also provided with skills for home care by following advised “Daily Activity Schedule”. The patient was encouraged to attend the Myasthenia Gravis Club and share disease experience with others. The report provided a reference to our fellow nurses in their clinical practices.