照顧一位初次罹患肺結核病人之護理經驗

A Primary Care Nursing Experience of A Patient with Tuberculosis

本文是描述一位因下背痛導致雙腳無力個案卻初次診斷出罹患肺結核之護理經驗。護理期間2013 年4 月12 日至4 月19 日運用歐倫自我照顧理論照護直接護理，藉由訪談、觀察、身體評估、病歷查閱、訪視等方式收集資料，確立個案主要健康問題共四項：服藥不遵從、焦慮、社交隔離及身體活動功能障礙等。經由護理系統之完全代償、部份代償、支持教育性護理概念提供相關護理措施，在護理過程中藉由深入的評估，給予個別性、整體且連續性的護理，建立個案對疾病療程、藥物治療的正確觀念作用，包括利用桌曆記錄服藥成效等策略，提升個案對疾病治療及藥物遵從性。同時結合社會支持系統，透過落實進階都治計畫(DOTS-plus)，嚴格監督個案服藥過程，期望藉由此次經驗，能提供護理人員日後照護類似病人的參考與運用。

This article described the nursing experience of caring an elderly patient being discovered as having tuberculosis due to low back pain with lower limbs weakness. During the nursing period from April 12 to April 19, 2013, the author approached the patient using Orem’s theory of interview, observation, physical assessment, chart review and visit methods. Results from this nursing experience showed that the patient had four health problems: noncompliance to medications, anxiety, social isolation, and impaired physical mobility. Through the nursing system, complete compensation, partial compensation, and supportiveeducation were effectively offered. An individualized and continuous care were provided to help the patient to obtain accurate knowledge about drug effects in the treatment course and then enhanced the compliance by recording medication time by desk calendar. At the same time, social support system and supervision of medication through DOTS-plus were utilized. The authors helped the patient to regain health in the long course of treatment. Through this case report, the authors wish to share the experience with nurse professional to promote the care of similar patients in the future.