一位肝移植合併肝硬化青少年的護理經驗

Nursing Experiences of Caring for an Adolescent vwith Liver Transplantation Complicated with Post-Operative Liver Cirrhosis

本篇報告是在描述一位膽道閉鎖接受肝移植術後併發肝硬化青少年之護理經驗。筆者於護理期間2007年5月22日至5月30日止，經由直接照顧、會談、觀察等方式，並運用同理心、陪伴和關懷建立良好護病關係，依羅氏適應模式評估，收集主客觀資料並加以歸納分析，確認個案有「體液容積過量」、「無望感」、「預期性哀傷－－家屬」、「營養少於身體所需」等健康問題。在護理過程中筆者藉由傾聽、關懷及指導，與個案共同研擬日常作息活動計畫，引導個案說出自己的想法，並透過醫療團隊與案母討論個案治療方針，降低擔心與焦慮等情緒，希望經由護理措施的介入，讓個案不僅減輕身體的不適，與案母間互動增加，更能獲得良好的心理支持及家庭照護，以達成適應目標及最好的健康狀態。

This report described the experiences of caring for a biliary atresia male adolescent with liver transplantation who also suffered post-operative liver cirrhosis. During the period of nursing care, from May 22, 2007 to May 30, 2007, through observation or conversation, the author utilized empathy and companionship to establish a good patient-nurse relationship. The author used the Roy’s adaptation model to evaluate, collect, and analyze the data and confirmed that the patient had health problems such as “volume overloading”, “hopelessness”, “anticipated sorrow of his family”, and “nutrition loss in the body”. During this period, the author prepared a daily activity schedule with the patient and led the patient express his own ideas. The author also discussed with the patient’s mother about the treatment guidelines and reduced the feelings of worrisome and anxiety. These measures reduced discomfort and improved the interactions between the patient and his mother. The patient was finally able to achieve better adaptation and obtain the best health conditions.