一位酒精依賴併發胰臟炎於加護中心的照顧經驗

Nursing Care Experience for A Patient with Alcohol Dependence and Concurrent Pancreatitis in an Intensive Care Unit

本文為描述一位酒精依賴併發胰臟炎,又承受酒精戒斷之痛苦,甚至出現意識混亂,躁動不安及面對死亡的威脅之患者的照護經驗。護理期間為自2013年4月17日至5月7日於內科加護病房。利用溝通及會談的方式,加上運用高登(Gordon)十一項健康功能評估法來分析個案資料,歸納出個案主要的護理問題,包括:急性疼痛、急性混亂/與戒斷酒精相關及家庭運作過程改變:酒癮/酗酒致家中成員疏離相關。在護理過程中建立良好的護病關係,在急性疼痛方面除以藥物止痛,同時教導放鬆技巧,並適時協助增加舒適感以減緩急性疼痛,同時利用酒精戒斷評量表評估個案症狀,執行預防性之護理措施避免個案受到傷害,此外引導個案說出自己的想法,並透過醫療團隊探討提供相關資訊,讓個案及個案家屬對疾病及治療有正確認知,協助強化與家人之互動,不斷支持與鼓勵,引發個案自我戒酒之決心,藉由參與戒酒病友會的經驗分享,使個案更能獲得良好的心理支持,且積極接受治療,以達到最好的健康狀態。建議臨床護理人員照顧類似病人時,除了減輕病人不適外,亦應注意心理層面及家人之間互動情形,提供個別性的護理,進而改善預後並增進病人的生活品質。

This article describes the nursing care experience for an alcohol-dependent patient with concurrent pancreatitis presenting with confusion, irritability, and death anxiety upon alcohol withdrawal. He was under treatment at the intensive care unit between April 17, 2013 and May 7, 2013. According to Gordon’s 11 Functional Health Patterns, the major problems assessed included acute pain, acute confusion, and alcohol withdrawal-related problems. Alcohol addiction also led to family dysfunction; in this case, family alienation. Building a good nurse-patient relationship, pain relief by medications, practical relaxation techniques, and injury prevention were performed during the nursing care period. His determination to remain abstinent was strengthened by improved family relationships, medical and mental support as well as group therapy, which all contributed to improve the prognosis.