一位皮肌炎病人之護理經驗

The Nursing Experience ofCaring a atient with Dermatomyositis

本文敘述一位罹患皮肌炎的病人，由於疾病因素導致四肢肢體無力而至復健科病房住院接受復健治療，在其面臨身體失能、吞嚥障礙等問題而產生無望感時，藉由建立良好護病關係、復健護理、與重建自信心之護理經驗。護理期間自2010年10月21日至2010年11月17日，筆者運用會談、觀察、身體評估等方式收集病史，並以Gordon十一項功能性健康模式為評估指引，經評估發現個案之護理問題有：1、高危險性肺吸入2、身體活動功能障礙3、無望感。筆者於護理過程中，以主動關懷、陪伴等方式與個案及家屬建立良好的護病關係，透過協助個案參與復健運動，指導個案及照顧者翻身轉位及吞嚥技巧，幫助個案盡可能達到最佳的功能性及日常生活自我照顧能力。此外，藉由傾聽病人心聲及分享相關案例經驗，以增強個案對治療計劃的信心度，及早接受病情變化，減輕疾病造成的失能與無望感。期望藉此護理經驗分享，做為日後護理人員照顧類似病人的參考。This case report is the nursing experience on a patient suffering from dermatomyositis. The patient felt hopeless when facing the disability caused by the disease. We helped him with a good relationship between the nurse and the patient, rehabilitation nursing, and rebuilding the patient's confidence in himself. We collected the patient's information by means of interview, observation, and physical evaluation during nursing from October 21st, 2010 to November 17th, 2010. Gordon's eleven Functional Health Patterns were administered for the indication of evaluation. In analysis, it was identified that the patient had the nursing problems of: 1. High risk of aspiration; 2. Impaired physical mobility; and 3. Hopelessness. In the nursing process, we made good interaction with the patient and his family by active caring and spending time with them. In order to help him to have a better function and independence in the activities of daily life, we assisted him to commit rehabilitative exercise and learn the skill of swallowing food and moving. In addition, we aimed to enhance his confidence on medical plan, help him to accept his disease, and reduce his sense of inferiority and hopelessness by listening to him and sharing the experience of other cases. This nursing experience might give some nurses the comprehensive nursing of similar cases.