一位肺結核合併氣胸復發患者之護理經驗

The Nursing Experience for a Patient with Recurrent Pulmonary Tuberculosis Combining Pneumothorax

肺結核病是目前世界上分布最廣且最持久的人類傅染病，肺結核病患若不治療，除了有極高的死亡率以外、其維持陽性之傅染狀態更可能危害到其他社區民眾。本文旨在探討一位開放性肺結核併發氣胸患者，反覆入院接受隔離及裝置胸管治療，所面監的身、心衝擊與調適經過。筆者於95年7月24日至95年8月18日護理期間，運用觀察、會談及Gordon十一項健康型態等方式進行護理評估，確立個案有急性疼痛、焦慮、知識缺失等健康問題，藉由介入傾聽、提供支持、用藥指導等多項護理措施後，終使得病人的症狀獲得援解，並提昇個案對疾病的認知及自我照顧能力，進而改善其生活品質。

Pulmonary tuberculosis (TB) is the most widely spread and long existing human disease in the world. Without proper treatment, a TB patient is not only contagious with high mortality, but also endangers the community. The purpose of this article is to explore the physical and psychological impacts on the patient and the coping process of a TB patient with recurrent pneumothorax due to repeated hospitalizations for chest tube placement and isolation, The author conducted a daily nursing assessment through observation, interview, and the use of Gordon's 11-item functional health scale. Based on the assessment from July 24 to August 18, 2006, the nursing diagnosis on the patient included acute pain, anxiety, and knowledge deficit. Nursing interventions such as active listening, emotional support, and patient education on medication were provided. The patient's symptoms lessened. The patient's quality of life was achieved by enhancing the cognition of disease and the ability of self care.