一位年輕女性初次診斷肺結核之照護經驗

Nursing Experience of Patient Newly Diagnosed with Pulmonary Tuberculosis

本篇乃是探討一位年輕女性初次診斷為肺結核，個案因服抗結核藥物及入住隔離病室內而產生之護理問題。護理期間自 2010 年 7 月 4 日至 7 月 20 日，筆者運用 Gordon 十一項健康功能型態評估，以觀察、會談及傾聽方式進行資料收集，分析發現確立個案有主要三個護理問題為知識缺失、社交互動障礙、營養狀況改變 /少於身體需求。針對其問題給予的護理重點包括：加強個案對疾病了解，如傳染途徑、藥物治療產生副作用，並提供網路資訊查詢及加強護理衛教，增加個案對疾病了解認識。住院過程中，協助個案面對因於疾病所引發之治療性隔離，主動提供個案心理支持與鼓勵，並增加病室內設備與外界互動，以建立良好護病關係。故在照護此個案時除了給予心理支持外，並且提供個案營養攝取方面衛教，增加其免疫力、促進疾病康復，協助個案解決上述之護理問題，讓個案以正向心態面對疾病並且完整接受治療；依病程進展及需求規劃合宜的護理措施，提供病人整體性照護，使病人達到最佳健康狀況，此次護理經驗希望能與醫護人員分享。

This study explored the physical and psychological impacts on a young female newly diagnosed with pulmonary tuberculosis and admitted to the negativepressure isolation ward. Nursing care was provided from 4th to 20th July 2010. Gordon’s 11 functional health patterns were used as the framework for patient assessment with data collected via observation, listening and communication. Analysis results revealed three major problems of the patient, namely knowledge deficiency, inadequate nutrient intake and impaired social interaction. Nursing intervention included education on pulmonary tuberculosis-related knowledge, such as disease transmission, side effects of drugs and the importance of completing the entire treatment course. Moreover, emotional support was offered and entertainment and communication facilities were provided in the ward to release the patient’s anxiety of isolation treatment. Furthermore, in order to boost immunity and promote rehabilitation, recommendations on nutrient intake were given. Under integral and individualized care, the patient developed an optimistic attitude toward the disease and treatment. This case study can be used as a reference for nurses taking care of patients with pulmonary tuberculosis receiving isolation treatment.