一位多重抗藥性結核病患不遵從服藥之護理經驗

Nursing Experience of a Multi Drug-Resistant Tuberculosis Patient with Drug Noncompliance

本文旨在探討一位多重抗藥性結核(Multi Drug-Resistant Tuberculosis, MDR-TB)病患不遵從服藥之護理經驗，於2007年5月18日至7月19日護理期間，採Gordon十一項健康功能型態評估，分析個案生理、心理、社會與接受自我健康維護之意願和能力，確立個案有：營養少於身體所需、不遵從、焦慮、社交隔離等健康問題。在護理過程中筆者提供個別性、連續性的護理，建立個案對疾病療程和藥物治療的正確觀念，強化其服藥遵從性，同時結合社會支持系統，透過落實「進階都治計畫」(DOTS-plus)，嚴格監督個案的服藥過程，協助在治療的漫長歲月中逐漸重獲健康。期許本文的討論能在專業領域中達到經驗分享，以發展更有效的護理措施。

This paper discussed the nursing experience of a MDR-TB patient with drug noncompliance. The period of care was from May 18 to July 19, 2007. Using the Gordon’s 11 Functional Health Patterns, the authors evaluated the bio-psycho-social aspects of the patient’s status and assessed the willingness and ability of self health care. The main health care problems were: malnutrition, noncompliance, anxiety and social isolation. During the care process, the authors offered an individualized and continuous care to help the patient to obtain accurate knowledge about drug effects in the treatment course, and then enhanced the compliance. At the same time, utilizing the social support system, and the face-to-face supervision of medication through DOTS-plus, the authors helped the patient to regain health in the long course of treatment. Through this case report, the authors wish to share the experience with nurse professionals to promote the care of similar cases in the future.