照顧一位B型肝炎患者急性發作之護理經驗

The Nursing Experience of Caring for a Patient with Hepatitis B Acute Attack

本文描述一位B型肝炎患者急性發作，由肝臟衰竭到痊癒的照護過程。疾病發作期間，個案承受著症狀所產生的不適，害怕面臨死亡，對疾病是否能治癒產生無力感。筆者以Gordon十一項功能性健康型態進行評估，運用觀察、會談等技巧收集資料，護理期間自2013年11月16日至12月4日，確立護理問題為體溫過高、活動無耐力、無力感、睡眠形態紊亂及知識缺失。在照護過程中，除了透過藥物控制症狀所產生的不適外，與個案保持良好溝通及護病關係，提供適切的護理措施，包括：鼓勵表達內心感受，陪伴及傾聽等情緒支持，以減輕個案的無力感。居家照顧部分，主動提供B型肝炎照護相關資訊，衛教監測及處理疾病導致的問題，以增強個案對疾病的控制感，使其有信心在接受治療後重返職場。建議未來能建置完整及系統性的B型肝炎照護標準及衛教內容，提供給病患和家屬，並期盼此照護經驗分享給臨床同仁參考。

This paper describes the experience of caring for a patient with hepatitis B acute attack. During the time of admitted in a medical center, the patient faced not only the physical discom-fort but also psychological distress regarding to the progress of disease and feeling of power-lessness. We used observation and interviews to collect information according to Gordon's 11 Functional Health Patterns to assess the patient's nursing problems, from 16, November to 4, December, 2013. The patient pre-sented with hyperthermia, activity intolerance, power-lessness, disturbed sleep pattern and deficient knowledge. We administrated medicine to diminish the physical discomfort and estab-lished good communication by encourage the patient to talk about his feelings, to accompany with and to listen to and support the patient. To prepare for discharge, we provided care guide-lines of hepatitis B to enhance the patient's ability to deal with the disease. It is suggested that the systematic healthcare stand-ards for hepatitis B should be established and health education brochure should be circulated to the patients and their families. Hope the caring experience can provide references to the health providers who care for the patients with the same or similar health problems.