照護一位診斷初期愛滋病毒感染者之護理經驗

The Nursing Experience of a HIV (+) Patient in the Diagnostic Stage

本文是描述一位初診斷感染愛滋個案的照護經驗，起初個案因缺乏對疾病正確的認知及害怕曝光，而引發逃避、否定、焦慮等負向情緒反應。筆者於護理期間（2008年6月28日至2009年2月20日）以Gordon11項功能性健康形態評估為架構，經由門診照護、觀察及諮商會談方式收集資料，發現個案有三個護理問題：一、健康維護能力改變：對愛滋的傳染途徑、治療、預後的資訊不足；二、焦慮：擔心愛滋診斷曝光讓家人知道；三、身體心像紊亂：因愛滋診斷導致負向的自我看法。護理過程中經由提供個別性的衛教；主動聯繫與表達關懷，在顧全隱私下，協助案妻與男友完成愛滋篩檢，並鼓勵表達及教導焦慮處理方法；營造接受的治療環境，強化支持力量以及引導正向思考等護理措施，成功協助個案建立對愛滋病正確的認識、重整混亂情緒以及恢復對自我概念的正向思考；希望藉此照護經驗的分享，提供臨床照護人員在面對愛滋診斷初期個案時之參考。This case report was to describe a nursing experience of a HIV (+) patient in the diagnostic stage. The nursing period was from June 28, 2008 to February 20, 2009. Due to the lack of the knowledge of AIDS and scare of disclosure, he suffered from the negative emotions of avoidance, denial, and anxiety. Gordon's Eleven Functional Health Patterns was applied to assess all the nursing problems. After observation and interview in the clinic care, three nursing problems were found which included 1. lack of the knowledge in transmission route, treatment, and prognosis; 2. anxiety due to the scare of disclosure in the diagnosis of AIDS to his families; 3. body image disturbance due to the discrimination of social reaction. The nursing interventions included providing individual education, actively contacting and expressing the caring, helping his wife and boyfriend to finish the HIV test in a confidential environment, encouraging him the way to express and deal with the anxiety, managing the therapeutic atmosphere, promoting the power of support, and guiding the positive thinking. The nursing care outcome revealed that the AIDS related knowledge of the case improved. His emotion was re-organizing, and positive self concept was re-gaining. The experience could be the reference of providing care to the HIV (+) or AIDS patients who are in the diagnostic stage.