照護一位肌肉強直症併發吸入性肺炎病人之護理經驗

A Nursing Experience of a Myotonic Dystrophy with Aspiration Pneumonia Patient

本文係探討照顧一位罹患第一型肌肉強直症併發吸入性肺炎病人之護理經驗。筆者照護期間2012年11月21日至12月11日，運用Gordon十一項功能性健康型態為評估工具，藉由觀察、會談、身體評估及參與照護進行整體性評估，確立病人健康問題有呼吸道清除功能失效、身體活動功能障礙、焦慮、照顧者角色緊張、高危險性感染及營養改變少於身體所需等。照護期間筆者針對病人健康問題提供適切的護理措施，透過持續性及主動關懷的態度與病人建立信任性護病關係，鼓勵病人及家屬表達內心焦慮，運用護理專業知識，提升病人及家屬對疾病照護認知，預防合併症發生，透過專業醫療團隊共同照護及社會資源的運用，擬定個別性之肢體運動訓練計畫，維持病人最佳健康狀態及增加自我照護能力和家屬參與照護，使其能以正向態度面對疾病侵襲並有連續性整體的醫療照顧，以達到全人之護理。

This article is a nursing experience of a myotonic dystrophy with aspiration pneumonia patient. Data were collected through interview, observation, and physical assessment. Gordon's 11 Function Health Patterns Assessment criteria were used to evaluate the patients from November 21 to December 11, 2012. The health problems included ineffective airway clearance, impaired physical mobility, anxiety and caregiver role strain, infection, and malnutrition. Measures were established through sustained and proactive caring attitude and patient trust of nursing-patient relationship in order to encourage patients and their families to express their inner the use of nursing knowledge, to enhance the patients and their families on disease care awareness, to prevent complication under the common care through professional medical team and the use of social resources, to develop individual training programs of the limb movement, and to maintain optimal health and increase patient self-care ability and families to participate in care, so that the patient can positively face the disease under the overall continuity of medical care in order to achieve holistic care.