一位「立談之間」同意捐贈之活體肝臟捐贈者的護理經驗

The Nursing Care Experience of a Living Liver Donor Who Decided to Donate Immediately

本文描述一位剛成年的學生，得知叔父不能捐贈的訊息，又面臨著父親生死關鍵時刻，立談之間表示有捐贈意願並迅速接受肝臟捐贈評估與手術之護理經驗。筆者護理期間為2013年08月16日至08月24日，以羅氏適應模式為評估指引，歸納個案有「恐懼」、「焦慮」和「急性疼痛」之健康問題。藉由引導個案表達出手術心理壓力與感受、提供相關文獻讓個案了解術後併發症、肝臟再生能力及術後照護資訊，並使用藥物與其他技巧控制來緩解疼痛。個案於住院期間，在生理及心理方面均承受極大壓力，需要護理人員關心與正向支持，協助渡過這個捐贈與移植的歷程，期望本個案的照護經驗能夠作為相關照護的參考，有助於規劃合宜及具個別性護理計劃，以促進捐贈者的健康。

This case report described the physical and psychosocial impacts on a young student who had donated her right liver for her father. After the interview, she decided to donate her liver without consideration and had received the pre-operation evaluation right away. The Roy’s adaptation model was used for assessment during her admission. The results showed that the patient experienced “fear”, “anxiety” and “acute pain”. We encouraged her to express her feelings about the operation in order to relieve her anxiety; informing her about possible operation complications and our standard post-operation care protocol to lessen her fear. We also provided sufficient information about liver regeneration capacity to her. Furthermore, both analgesic agents and non-pharmacological strategy were used to reduce post operation pain. Living liver donors were beard with tremendous both physiological and psychological stress during their hospitalization; therefore, they need both mental and medical support from nurses through their liver donation. We hope that this case report can be served as a nursing care model for living liver donors.