一位初次診斷為多發性硬化症個案之照護經驗

The Nursing Experience of a Patient with MS who Feel Hopeless

多發性硬化症為中樞神經系統去髓鞘疾病，突發的漸進性失能狀態，易使患者身心遭受打擊。本篇描述一位多發性硬化症個案因眩暈、複視以及入院後四肢肌力降低照護之經驗，個案因眩暈及四肢肌肉無力，導致無法執行日常生活活動、照顧家人，進而造成個案及家人身心衝擊。筆者照護期間自2011年1月21日至2月1日，運用Gordon十一項健康功能型態架構評估，以觀察、傾聽等方式，收集資料，確立個案有身體活動功能障礙、無望感、照顧者角色緊張之護理問題。針對個案問題，透過同理心、傾聽及陪伴等方式提供個別性護理措施，主動及被動關節運動指導，維持肢體活動功能，增加對疾病的認知，促使個案勇敢面對疾病，積極參與復健運動，預防疾病復發；同時也教導案夫照顧技巧及情緒感受的表達，使得家屬成為照顧病人最大支柱。期望藉由此個案照護分享，提供臨床護理人員日後照護類似病患之參考。

Multiple sclerosis (MS) is a type of demyelinating disease of the central nervous system. MS is a sudden, yetprogressive disability that impacts patients physically and mentally. This study describes the nursing experience of apatient with MS typified by a decrease in limb muscle strength after hospitalization. The patient was unable to do dailyactivities and take care of family members due to dizziness and double vision treatments, as well as a lack of musclestrength, all of which affected the patient physically and mentally. During the nursing period from 21 January to 1February 2011, we collected data from physical assessments, observations, and attentive listening. We applied Gordon’s11 Functional Health Patterns to establish nursing problems such as impaired physical mobility and feelings ofhopelessness in addition to caregiver role strain. Individual nursing measures such as empathy, attentive listening, andcompanionship, as well as active and passive range-of-motion guidance, were provided for maintaining limbfunctionality and increasing the patient’s knowledge of the disease. We guided the patient to bravely face disease andactively participate in rehabilitation exercises to prevent recurrence of the disease. The husband of the patient wastaught care skills and was encouraged to express inner emotions to give positive support for the patient. Nursing staffalso assisted family members in receiving psychological care. The purpose of relating this nursing experience is toprovide clinical nursing personnel with a reference for taking care of patients with similar diseases in the future.