一位多發性硬化症病人之照護經驗

The Experience of Caring a Multiple Sclerosis Patient Removed Tracheastomy Tube Successfully with Integrative Medicine Care

多發性硬化症為一侵犯中樞神經系統慢性、退化性之自體免疫疾病，此疾病除了造成身體功能改變外，亦對生理及心理造成不同程度的影響。本文係探討一位多發性硬化症病人在入住中醫病房期間，筆者於2011年6月1日至2011年7月13日護理期間，採用直接參與、會談、觀察等方式收集資料，確立個案有呼吸道清除功能失效、失眠、焦慮等健康問題，於護理過程中透過指導有效痰液清除及呼吸訓練方法，協助個案解決呼吸道清除功能失效問題，教導家屬給予個案穴位按壓協助解決失眠，並藉由環境與音樂治療提供個案情志護理，進而處理焦慮之健康問題。此護理經驗不僅使個案生理、心理及靈性得到良好的調適，並可順利移除氣切管路出院返家。期望藉由照護此個案之護理經驗，提供臨床護理人員在面對照護此類似個案之參考，以提升護理照護品質。

Multiple sclerosis (MS), a chronic and degenerative autoimmune disease, invades central nervous system, compromises body function, and causes physiological and psychological problems to varying degrees. This article presents a nursing experience of successfully removing the tracheostomy tube from a MS patient who was admitted to Chinese Medicine ward for intervention and integrative care. The author cared the patient from June 1st to July 13th in 2011. By means of Chinese Medicine holistic nursing (look, smell, ask pule), direct engagement, conferences, observation, and data collection, the following health issues were identified: problems of respiratory tract clearance, insomnia, and anxiety. Through active interventions such as effective mucus clearing and breathe training method for problems of respiratory tract clearance, acupressure treatment for insomnia, and music therapy for anxiety, the patient had great improvement on health issues. Nursing experiences in this case not only had positively physical, psychological and spiritual adjustment, but also helped the case successfully remove the tracheastomy tube and discharged home. Reporting of integrative care of nursing experience through this case is to provide the clinical staff with a reference to similar cases, to improve the quality of nursing care in the face of care strategy.