愛滋帶原者感染新型冠狀病毒之心理健康照護經驗

Experience Providing Psychological Care to an HIV-Positive Patient With SARS-CoV-2 Infection

傳染性疾病擁有高度被烙印及入罪化之特性。本文敘述愛滋帶原者合併感染新型冠狀病毒之照護經驗。文中個案因確診感染新型冠狀病毒入院隔離，害怕使愛滋帶原者身分曝光且對於自己染疫後將新型冠狀病毒傳染給同住母親感到自責，罹病後懊悔不已，亟需護理介入支持。護理期間自2021年7月15日至7月29日，筆者利用面對面及監視器觀察、身體評估、電話會談及醫療團隊討論之方式進行生理、心理、靈性及社會四大層面之評估，確立個案有現存性感染、焦慮及情境性低自尊之健康問題。於照護過程中提供新興傳染性疾病個人衛生指導，並按時給予服用組合型抗病毒藥物以維持免疫力；護理人員作為個案唯一直接接觸對象，藉由建立信賴關係，關懷傾聽個案對於雙重感染者身分的擔憂，同理並保證其隱私權，接納其於隔離期間的負面感受，強化支持系統幫助渡過隔離期之心理壓力。此照護經驗顯示為傳染性疾病病人提供心理照護之重要性，建議政府與媒體能提供正確資訊以強化社會大眾對傳染性疾病的認識與了解，達到去除污名，創造更友善醫療環境。

Infectious diseases are often stigmatized and criminalized because of the way they are transmitted. An experience providing care to a 37-year-old patient with human immunodeficiency virus (HIV) infection who was admitted to a medical center's quarantine ward in July 2021 due to SARS-CoV-2 infection is described in this article. This patient lived with his mother, who was later diagnosed with COVID-19 as well. He was worried about his mother's health condition and, meanwhile, feared that information about his diseases and person would be exposed by the media. These stressors led to increased feelings of shame and anxiety and to situational low self-esteem. Several interventions were provided, including education regarding the importance of personal hygiene and of maintaining combination antiretroviral therapy (cART) to bolster immune system functions. During the isolation period, the nurses most regularly interacted with the patient directly. Thus, we worked to build the nurse-patient relationship by listening to the patient's worries, guaranteeing his privacy would not be compromised, and guiding him to express his emotions to reduce anxiety and enhance confidence. This experience demonstrated the importance of providing psychological care to COVID-19/HIV co-infected patients. We suggest that the government and media distribute correct and neutral information to destigmatize communicable diseases and to foster a friendlier healthcare environment.