運用「創造父母賦權機會模式」照顧一位肺炎鏈球菌引起溶血性尿毒症候群幼兒及照顧者之經驗

Nursing Experience of Applying COPE (Creating Opportunities for Parent Empowerment) Program for Caring for a Young Child with HUS (Hemolytic Uremic Syndrome) Caused by the Pneumonic Streptococcus and Caregiver

本篇個案報告是運用「創造父母賦權機會模式」，照顧一位因肺炎鏈球菌引起溶血性尿毒症候群幼兒及照顧者之護理經驗，護理期間自2005年11月25日至12月4日。藉由觀察及非結構的會談方式，以Gordon十一項功能性健康評估工具執行護理評估，確立護理問題為組織灌流改變、呼吸道清除功能失效、焦慮及照顧者角色緊張。運用「創造父母賦權機會模式」作為護理過程中與個案及照顧者互動的指引及護理措施的指導原則，以滿足患童的生理、情緒需求及照顧者角色功能；藉由照顧者描述患孩目前行為及情緒反應，促使其瞭解患孩住院期間之行為反應，以降低患孩及照顧者之焦慮；此外，利用床旁及時教學，讓照顧者瞭解如何參與患孩之照顧，促使照顧者參與患孩的照護，滿足照顧者角色及功能，並降低其壓力，以健康促進為目的，進而達成以家庭為中心之護理。

This article described the nursing care experience of applying the COPE (Creating Opportunities for Parent Empowerment) program for caring for a young child with HUS (hemolytic uremic syndrome) caused by the pneumonic streptococcus. The duration of nursing care was between November 25 and December 4, 2005. Through observation and non-structural interview, the care assessment was conducted based on Gordon 11 functional health evaluation. Nursing problems identified included tissue perfusion altered, airway clearance ineffective, anxiety and caregiver’s role strain. The application of the COPE program can be employed as the indicator for the interactions between the client and the caregiver during the care process and as the guiding principles for the care in order to fulfill the client’s physiological and emotional needs and the caregiver’s role functions. Through the caregiver’s descriptions about client’s current behaviors and emotional responses, it would enhance the understanding about the client’s behavioral responses during the hospitalization period for reducing the anxiety of the client and caregiver. In addition, the utilization of the instant bedside education would enable the caregiver to understand how to participate in the care of the client. Finally, promotion of the involvement of the caregiver in the care of the client and satisfy caregiver’s roles and functions, further alleviated caregiver’s pressure and achieved the family-centered care.