運用Swanson理論協助一位初診斷愛滋病患心理社會調適之護理經驗

A Nursing Experience of Helping a Patient with HIV with Psychosocial Adaptation

現今全球愛滋病感染人數不斷地上升，社會對愛滋病患仍普遍存在污名烙印現象。本篇是運用Swanson關懷照護理論，協助一位年輕男同性戀初診斷愛滋病患心理社會調適之護理經驗。護理期間為2011年4月13日至2011年4月24日，透過直接照護，運用病歷查閱、觀察、會談及身體評估等方式，以整體性護理評估，確立個案有焦慮、高危險性行為及健康尋求行為三大健康問題。筆者運用Swanson的關懷照護理論，與個案建立治療性及信任的護病關係、鼓勵表達內心感受，尋求家人的支持，使其重拾信心發展正向的調適技巧，增加病患及家屬對疾病的認知並順利接受雞尾酒治療。期盼透過照護此個案之護理經驗，能提供臨床護理人員照護愛滋病人之參考。

As the number of patients with HIV infection increases, patients with acquired immunodeficiency syndrome (AIDS) not only suffer from the disease but also are burdened with stigma. The article describes a nursing experience of assisting a patient with AIDS in psychosocial adaptation. The patient was homosexual and newly diagnosed with AIDS. The nursing period was from April 13th to April 24th, 2011. Through an integral nursing assessment including observation, interview, chart review, and physical examination, three major nursing problems were identified: anxiety, high risk of sexual behavior, and poor health-seeking behavior. Following Swanson's theory, the author built a therapeutic and trusting relationship with the patient, encouraged the patient to freely express internal feelings, helped the patient's family understand the disease and accept cocktail therapy, and received the family's full support. Thereafter, the patient rebuilt his self-confidence and developed positive adaptive skills. The patient and family members could positively face the disease and complete therapy. The author expects that this experience can be shared and used as a reference for other clinical nurses taking care of patients with AIDS.