照顧一位外籍孕婦罹患罕見疾病面臨流產手術於加護病房護理經驗

The Nursing Experience of Taking Care of a Foreign Expectant Mother with a Rare Disease Facing Artificial Abortion in ICU

本文是描述一位24歲外籍孕婦，於懷孕初期發現罹患罕見疾病噬血症候群，經歷入住加護病房的身心衝擊、面對醫療文化背景差異，及因治療而須執行人工流產手術之生理上的不適及心理衝擊等過程之護理經驗。於2007年1月26日至2月8日照護期間，筆者以Gordon十一項功能性健康型態評估為依據，藉由直接會談、傾聽、觀察方法收集資料，確立其護理問題之優先順序為氣體交換障礙、睡眠型態紊亂及焦慮。筆者透過良好的治療性關係建立，協助個案了解疾病及提供人工流產手術護理相關資料，並利用簡易圖片或衛教本協助個案了解治療及手術過程、加護病房環境和儀器設備與作用等，並持續予心理支持，協助面對疾病及入加護病房的焦慮等壓力之護理過程。因個案疾病所需之照護特殊，期望能將此護理經驗分享，提供臨床護理人員在照顧外籍孕婦合併罹患罕見疾病時之參考。This article described a 24 year-old foreign expectant mother who got a rare hemolytic uremic syndrome and did not adapt to the ICU, such as the discrepancy of cultural background in medical practice, and the physical and mental impact of artificial abortion. From Jan. 26 to Feb.8 in 2007, the author collected data by direct interview, listening and observation based on the evaluation of Gordon's 11 functional health patterns to establish the priority of nursing: gas exchange disturbance, sleeping disturbance and anxiety. The author established a good therapeutic relationship and provided the related case of disease and information of nursing care of artificial abortion and used photos and patient handout forms to help patients realize the procedure of treatment and operation, ICU environment and medical equipments. Mental support was persistently given to help her confront the disease and relieve her pressure and anxiety in ICU. Due to the special case of disease, it is hoped that the nursing experience in this study can offer some references for further care of a foreign expectant mother who gets a rare disease and faces artificial abortion.