一位全身性紅斑性狼瘡併有全身性硬皮症之護理經驗

Nursing Experience Caring for a Patient with Systemic Lupus Erythematosus and Systemic Sclerosis

本文描述一位年輕女性罹患全身性紅斑性狼瘡合併全身性硬皮症，面對身體外觀改變與活動受限雙重衝擊壓力調適之護理經驗。護理期間自2015年4月1日至4月9日，筆者藉由觀察、會談、傾聽與運用Gordon十一項健康功能型態評估個案，確立個案有慢性疼痛、身體活動功能障礙、與身體心像紊亂等健康問題。照護期間發現個案飽受身心痛苦，筆者運用同理心、耐心、及傾聽方式，與個案建立信任關係。針對個案需求提供全身性紅斑性狼瘡與硬皮症的衛教指導，提升自我照護知能與技能；協助個案正向治療及重建自我概念價值。 This case study describes the nursing experience of taking care of a young woman with systemic lupus erythematosus and systemic sclerosis and details how the patient’s body image changed and how her conditions progressively limited her daily activities. The author used clinical observation, interviews, and listening skills guided by Gordon’s 11 functional health patterns to identify the patient’s major health problems from April 1st to April 9th, 2015. Three major nursing diagnoses were made: chronic pain, impaired physical mobility, and disturbed body image. Through an individualized care plan that employed sympathy, passion, listening, and building a trusting patient–nurse relationship, we successfully led the patient to express her inner concerns. Moreover, the patient improved her self-care knowledge and skills through receiving health education and reconstructed her self-esteem, adopting a positive attitude to face the disability caused by her disease.