照顧一位Guillian-Barre症候群學齡期兒童之護理經驗

Nursing Care of a School-Aged Child with Guillain-Barre’ Syndrome (GBS)

本篇為一位七歲的學齡期病童因肌肉痲痺及輕微咳嗽至醫院求治，經醫師診斷確認為Guillian-Barre症候群而需住院治療。筆者於2007年5月26日至6月1日護理期間，運用Gordon十一項功能性健康型態評估進行資料收集與分析，發現賴小弟因住院與身體活動受限而產生焦慮，又因侵入性治療造成疼痛，利用疼痛評估量表了解其疼痛程度，且運用遊戲治療與復健活動降低賴小弟焦慮，進而提昇與醫護人員的信任感、降低對治療的抗拒、願意配合與遵從醫療行為。希望藉此護理經驗，使兒科護理同仁瞭解在照顧此神經肌肉病童時，能依照其發展階段，選擇合適的疼痛評估量表評估疼痛，並有效地運用遊戲治療以協助病童配合復健課程，幫助病童降低住院焦慮與減輕疼痛，並恢復其身體活動功能。

This case report describes the nursing experience of a seven year-old school-aged child suffering from muscle paralysis and mild cough who came to the pediatric clinic for help. He was diagnosed as Guillain-Barre’ Syndrome (GBS) for the first time and asked for hospitalization. From May 26 to June 1, 2007, the author applied Gordon 11 functional health patterns to collect and analyze the data. The major nursing problems were anxiety and pain due to hospitalization, physical activity limitation, and invasive treatment. In addition to using pain assessment scales to assess the pain of the client, therapeutic play and rehabilitation were adopted to release the anxiety and establish trust between the health providers, and decline the refusing of treatment. Nursing experience from this case study might help pediatric nurses who take care of GBS children, and thereby promote their physical function and release their anxiety and pain.