照顧一位COVID-19病人在隔離期間之護理經驗

Nursing Experience of Caring for a Patient With COVID-19 During Isolation

2019年底嚴重特殊傳染性肺炎（coronavirus disease-2019，COVID-19）襲捲全球。本文描述一位女性旅遊歸國後確診COVID-19，於2020年2月5日至2月29日住院隔離期間，作者使用羅氏適應模式之第一層次進行整體性身、心、社會評估，以面對面會談、電話訪談、及遠端監視系統觀察等技巧，收集個案健康照護問題；透過第二層次評估確立護理問題有：（1）與COVID-19有關之現存性感染；（2）對疾病不確定、媒體報導擔心個資曝露、家人不諒解所產生之焦慮。由於隔離病房特殊性，住院期間透過遠端生理監視系統監測個案生命徵象，並衛教發燒、呼吸喘時應變方式，提高個案在隔離病房自我照顧能力，自行儘早解除生理不適；為了病人環境安全減少交叉感染，加強環境清潔。為緩解焦慮，與個案建立良好治療性人際關係，每日撥打10－60分鐘關懷電話，提供個別性護理措施，及運用網路撥放影音教導正念冥想，改善個案之焦慮。COVID-19病人照護是全新的經驗，期望此篇經驗分享可做臨床護理師照顧之參考。

The ongoing coronavirus disease-2019 (COVID-19) epidemic continues to have a global impact. This article describes the author's experience providing nursing care to a female patient who was diagnosed with COVID-19 after returning to Taiwan from overseas. During the patient's period of isolation (February 5th to February 29th, 2020), the author used Roy's adaptation model to perform first-level holistic physical, psychological, and social nursing assessments and collected healthproblem information using face-to-face interviews, telephone interviews, and observations via a remote monitoring system. A second level of assessment confirmed that the problems faced by the patient included (1) existing infections related to COVID-19 and (2) anxiety related to uncertainties about disease prognosis, forgiveness from the family, and potential violations of personal privacy by the media. Due to the special nature of the isolation ward, the author used a remote physiological monitoring system to monitor the vital signs, fever, and shortness of breath status of the patient to quickly decrease her physical discomfort and to improve her self-care ability during hospitalization. Environmental cleanliness was strictly maintained to reduce the risk of cross-infection and ensure patient safety. To alleviate patient anxiety, the author established a good therapeutic interpersonal relationship with the patient by making 10–60 minutes of caring calls to her each day, by providing individual care measures, and by using the Internet to play audio and video to teach mindfulness meditation. Caring for COVID-19 cases is a completely new experience. The author hopes that this experience may be used as a reference for caregivers.