一位川崎氏症患童及主要照顧者之護理經驗

The Nursing Experience for a Kawasaki Syndrome Child and His Caregiver

本篇個案報告是敘述一位罹患川崎氏症患童及其主要照顧者之照護經驗。於照護期間（2005年12月28日至2006年1月3日）應用羅氏(Roy's)適應模式為評估指引，並運用觀察、會談等技巧收集資料以確立個案的健康照護問題包括：體溫過高／因川崎氏症所引起，口腔黏膜障礙／因口腔清潔不良及口腔內潰瘍所引起，照顧者角色緊張／對川崎氏症的症狀及處理和對未來受照顧者的健康狀況與照顧者提供照顧的能力感到擔憂。經由密切監測體溫變化，增加體液的補充，提供持續性及個別性的護理措施，讓個案於住院期間身體及心理達到舒適，並藉由良好的護病支持系統，陪伴、傾聽，讓案母抒發其情緒感受，進而獲得對川崎氏症較正確的認識及判斷。希望藉此護理經驗提供護理同仁，在照護此類患孩時，除了症狀解除外，家屬心理層面更不可忽略。

This case report describes experiences of taking care of a Kawasaki disease child and his caregiver. Data was collected from December 28th, 2005 to January 3rd, 2006. During the time of nursing processes, the clinical nurse applied Roy’s adaptation model to collect subjective and objective information through interviews and observations to establish a health care problem list. The list included hyperthermia caused by the disease, oral mucous membrane altered because of the hygiene problems and oral mucous membrane ulcers; in addition, caregivers’ anxieties and strains because of the deficits of the knowledge of the Kawasaki disease and its future care. The nursing interventions included monitoring the patient’s body temperature, attention the complement of body fluid, and providing continuous and individual nursing cares. Besides, applied professional knowledge, attended listening to the patient, and empathy to encourage and support her to obtain knowledge of Kawasaki disease and how to make competent interventions. Through this nursing process, the clinical nurse strongly suggested that a nurse must concern the Kawasaki disease patient not only physical problems but also family caregiver’s psychological needs.