一位毒咖啡成癮個案之急診照護經驗

The Care Experience of Caring a Patient with Illicit Drug Addiction in Emergency

本文探討一名使用毒咖啡成癮個案之急診照護經驗。因毒咖啡成癮有行為怪異、產生幻覺及藥物戒斷症候群，導致生理及心理面臨多重衝擊，2017年5月9日至5月11日照護期間，藉由Gordon十一項健康功能型態為評估架構，運用身體評估、觀察、會談、傾聽及溝通等方式收集資料，確立個案主要之健康問題依序為體液容積不足、睡眠型態紊亂及個人因應能力失調。照護過程中個案不但面臨毒咖啡成癮產生橫紋肌溶解症，還要面臨毒品造成幻聽、幻覺的干擾，在團隊努力與個案及家屬建立良好治療性人際關係及互動，讓個案及家屬共同參與照護計畫，對於疾病有更深入了解及更能讓個案感受來自於家屬的關懷與支持，並協助持續追蹤後續狀況及戒毒門診之轉介，以提升整體照護完整性，使個案能盡早回歸社會，藉此經驗提供臨床護理人員在照護個案上之參考。

This article described the nursing experience of caring a patient with acute illicit drug poisoning in the emergency room. Patients addicted to illicit drugs usually present bizarre behavior, hallucination, and withdraw symptoms, resulting in multiple physical and psychological impacts. During the caring period from 09 May to 11 May, 2017, the Gordon's 11 functional patterns are used as the framework of evaluation. By physical evaluation, observation, consultation, and listening and communication, the main health problems are identified as dehydration, disturbed sleep, and personal adjustment disorder. The patient suffered from rhabdomyolysis and experienced visual and auditory hallucination. With the effort of teamwork and good therapeutic relationship between the patient and his family, we involved the patient and his family in the treatment decision making process. This helped the patient understand the illness and brought support from his family members. Finally, the care is completed with regular follow-up and referral to the detoxification clinic. We put effort in bringing the patient back to the society. We would like to share the experience as a reference for caring patients who are addicted to illicit drugs.