一位伺機性感染病人確診愛滋病之護理經驗

The Experience of Caring a Patient with Opportunistic Infections with Confirmed HIV

本文探討一位經由伺機性感染確診為愛滋病的病人，在住院期間歷經疾病的病痛折磨，並隨即被告知罹病到必須接受愛滋病的護理過程。照護期間自2015年4月8日至2015年4月29日，藉由直接照護、傾聽、觀察、會談、身體評估等方式進行資料收集與評估，依據Gordon十一項健康功能評估，確立病人的健康問題為：無效性保護能力、營養不均衡：少於身體需要、氣體交換功能障礙、無望感。在護理過程中建立友善的護病關係與信任感，針對病人個別性需求，提供疾病相關知識，以減輕伺機性感染帶來的身體不適感，運用飲食衛教指導強化病人進食意願，並教導病人蹶嘴式呼吸及擴胸運動，循序漸進讓病人換氣功能獲得改善。一旦病人確診愛滋病時，立即給予心理支持與關懷，透過醫療團隊共同照護及社福團體的力量，讓病人坦然面對疾病接受治療，進而適應疾病所帶來的生活改變，更重拾對生命的希望。期望藉此分享照護經驗，有助於臨床實務之應用，更加提升心理層面的照護品質。

This article discusses the infection diagnosis for an opportunistic HIV patient during hospitalization through repeatedly suffering the disease, and being informed falling ill to accept HIV. Data were collected and assessed during the period from April 8 to 29 in 2015 through direct care, listening, watching, and talks. The nurse assessed the patient with Gordon 11 Functional Health Status Assessment tool. The patient's problems were identified related to protection altered issues, such as suboptimal nutrition, impaired gas exchange and hopelessness. Building rapport in the course of nursing nurse-patient relationship and trust, providing disease-related knowledge to meet the patient's individual needs and to alleviate physical discomfort caused by opportunistic infections, and using diet education to fulfill patient's wishes and to teach patients to devise contingent measures in mouth breathing and breast enlargement exercises, the patient's breathing function gradually improved. Once a patient diagnosed HIV, immediate psychological support and care by a medical team and social welfare groups, the patient is more able to face diseases and treatment, and then adapt to diseases brought about by the change of life and regain his/her hope of life. It is hoped that the share of care experience contributes to clinical practice and enhances psychological dimensions of quality of care.