一位失禁性皮膚炎幼童之照護經驗

The Experience of Caring for a Child Suffering From Incontinent Dermatitis

本文係探討一位幼童因家屬照護不當導致失禁性皮膚炎之照護經驗。於2015年 3月27日至4月2 日照護期間，筆者運用Gordon十一項功能性健康型態評估收集個案身體、心靈、與社會方面等主、客觀資料。藉由觀察、身體評估、照護過程、關懷與溝通收集個案與案母資料，確立個案健康問題有：皮膚完整性受損、急性疼痛、照護者角色緊張。針對上述三項個案健康問題， 藉由個別性照護、持續性的主動關懷、傾聽與陪伴，與家屬建立良好的護病關係。依據個案喜好，運用治療性遊戲和注意力轉移技巧，以減輕個案換藥時的疼痛感受。照護期間也鼓勵家屬共同參與治療，並指導失禁性皮膚炎正確照護資訊，以降低家屬心中擔憂，並提升家屬照護能力及自信心，以利返家後個案能持續獲得完整的照護。也期望藉此照護經驗提供護理人員照顧類似個案之參考。

This paper describes the experience of caring for a child with incontinent dermatitis that was caused by improper family care. From March 27, 2015 to April 2, 2015, the authors used Gordon’s 11 functional health parameters to collect subjective and objective data on the physical, mental and social conditions of the care recipient. To understand the nursing-related problems, including impaired skin integrity, acute pain, and caregiver anxiety, the data for this case and his mother were conducted by observation, physical assessment, the process of caring, and communication. For the three nursing problems, we established a good relationship with the family by providing individual care, continuously active care, listening, and companionship. In order to reduce the pain during wound dressing, we used game therapy and an attention-transfer technique that was based on the case’s preferences. We encouraged family members to participate in treatment in order to ensure that the case continued to receive proper and continuous care after returning home. The authors taught the family members the correct information for treating incontinent dermatitis in order to reduce their concerns and to enhance their confidence and care abilities. We hope that this nursing experience may provide a reference for other nursing staffs when caring for similar cases in order to ensure appropriate quality of care.