探討嚴重急性呼吸道症候群患者之照護情形及需要

A study on Health Care and Needs for SARS Patients

本研究目的：一、瞭解某醫學中心嚴重急性呼吸道症候群以下簡稱通報患者人口學及疾病分佈；二、通報患者處置項目及健康問題；三、患者返家後適應及照護需要。研究樣本為南部某醫學中心隔離病房通報病例共例，方法是以回溯性檔案分析為主，檔案來源為病歷，電話訪問為輔。由三位資深護理人員調閱病歷並進行內容分析。結果顯示患者以男性居多；平均歲；感染來源不明者；平均住院天；出院時診斷為最多，次為肺炎；死亡率；出院動態以門診追蹤最多。入院症狀前三名為發燒、光呈現肺炎、喀痰；主要護理問題前三名依序為體溫過高、呼吸道清除功能失效、低效性呼吸型態；藥物使用以抗生素最多。返家後仍覺呼吸喘，家人的態度接納，受朋友、鄰居排斥。建議採取敏感度、精確度較高之篩檢工具，以及早確定診斷及隔離。患者於出院計劃中應特別強調有關肺部復健運動及個案管理，持續關懷與追蹤，以提供必要的醫療及心理輔導。

The purpose of this study was (1)to describe demographics, and geographicdistribution of reported SARS patients; (2)to understand treatment items and healthproblems; (3)to survey the coping status and health care needs after discharge. Thisretrospective study sampled fifty-eight reported cases. A chart review was implemented,using a standard recognized by three senior nursing staffs. The results revealed thatthe male gender was 63.8 %; the mean age 54.6 years old; the unknown infectionsource 41.4%; the mean admission day 9.28 days. The discharge diagnosis showed:SARS 31.0%; pneumonia 29.3%; followed by death 19.0%. The first three symptomsand signs were fever, pneumonia patch on X-ray film, and sputum. The first threenursing problems were hyperthermia, impaired function of airway clearance, andineffective respiratory pattern. 87% of patients were short of breath after returninghome, 100% experienced acceptance for family attitude, and 25% experienced rejectionby friends and neighbors. The study suggests to use higher sensitivity screen tools, toisolate appropriately, and to emphasize pulmonary rehabilitation exercise.