一位猛爆性肝衰竭病人面對無力感之護理經驗

Nurses’ Experience Helping a Fulminant Hepatic Failure Patient Face Powerlessness

本文描述一位病毒性肝炎急性發作導致猛爆性肝衰竭病人，因疾病過程的無法預測產生無力感之護理經驗，護理期間自2007年11月13日至2008年1月17日。筆者運用五大層面評估架構，以觀察、直接護理、會談等方式，進行整體性評估收集資料並確立問題。個案有體液容積過多、思想過程改變、焦慮、無力感與哀傷等健康問題。照護期間密切監測疾病進展，給予關懷、傾聽、心理支持，鼓勵表達內心感受，主動提供正確資訊與護理指導，讓個案與家屬了解疾病過程及返家自我照顧方法和注意事項，以減輕焦慮，增進自我控制感，協助個案與家屬以正向態度面對病情變化，共度艱辛過程。

The article describes a nursing experience with a powerlessness patient suffering from acute viral hepatitis exacerbation-induced fulminant hepatic failure. The period of care ran from 13 November 2007 to 17 January 2008. The Gordon 11-item health assessment scale was used to identify nursing process problems. Nursing diagnosis results included excessive fluid volumes, altered thought processes, anxiety, and physical powerlessness. Thus, while monitoring the patient’s physical condition, the nurse provided psychological support, teaching and information about the disease during patient hospitalization. The purpose was to promote patient and family abilities to deal with the illness and preparation for self-care after discharge, and, thus, enhance self control through reduced anxiety.