照護一位COVID-19防疫期間入住護理之家之新住民遷移壓力經驗

Nursing Experience of a Newly Admitted Nursing Home Elder who Suffered from Relocation Stress during COVID-19 Prevention Period

本文描述一位70歲女性長者經冠狀動脈繞道手術後出院，因白天家中無人照護，於COVID-19防疫期間入住護理之家，在首次離家又遇禁止家屬探視之長照機構防疫政策之下，身心備感壓力。筆者於2020年3月20日至5月20日期間，透過觀察、會談及身體評估等方式收集資料，運用Gordon十一項功能性健康型態評估，確立個案有因遷移至新環境而引發便祕、失眠及遷移壓力症候群等健康問題，為在防疫時期協助個案克服遷移壓力，筆者於照護期間依據個案習慣、活動安排、飲食指導、腹部按摩與穴位按壓等，重建個案排便型態及營造安心睡眠環境；此外更利用家中熟悉物品佈置新居環境，協助學習視訊使用，維繫親情交流，更與個案建立夥伴關係，傾聽理解並支持個案將過去生活習慣與喜好，漸漸重新帶入機構新居的日常之中。建議防疫期之機構入住照護，應及早注意新住民的身心變化，引導住民防疫視聽，加強機構生活支持感，均有助於新入住適應及其身心安適。

This report describes the nursing experience of caring an elderly hemodialysis patient who experienced catheter-related infections due to a lack of clarity regarding catheter care. Confronting dialysis and ineffective catheter care issues, the patient endured feelings of loss, hopelessness, and other negative emotions. The nursing care period spanned from December 17 to December 22, 2018. Data collection involved observation, interviews, listening, and reviewing medical records. Gordon's 11-items functional health pattern was employed to assess the patient's health problems, revealing three nursing issues: impaired tissue integrity, knowledge deficit, and hopelessness. Throughout the care period, the author established a strong nurse-patient relationship through active listening and encouraged family members to actively participate in the care plan. Visual aids, such as photos and videos, were provided to educate the patient and family members about proper catheter care, leading to a heightened understanding of its importance. Furthermore, when the patient encountered difficulties and felt helpless and hopeless, the author facilitated open communication and emotional expression by involving family members and other dialysis patients. The patient's thoughts and needs were respected, and psychological support was readily available. As a result, the patient developed a positive attitude towards home care, ultimately achieving and maintaining good health status after returning home.