運用健康識能概念於肺阻塞病人的護理經驗

本文在運用健康識能概念照護一位患有肺阻塞的65歲男性病人。照護期間自2020年8月28日至2020年9月4日，以整體性護理評估為架構，運用身體評估、溝通、會談技巧及查閱病歷等方式進行收集資料，照護期間與個案建立良好護病關係，發現個案有低效性呼吸型態、焦慮及無效性健康管理等健康問題，經提供噘嘴式呼吸、身體放鬆及有效性咳嗽的技巧，使個案有效的改善呼吸型態；運用傾聽與同理心理解個案焦慮因素為無法控制呼吸，教導個案使用自我評估量表評估每日呼吸喘程度及找出引發呼吸喘的高風險因素之預防及處理方式，使個案三個月內未再因急性發作入院，且改善其焦慮程度；運用健康識能概念教導肺阻塞疾病知識及注意事項，使個案可運用具圖片的肺阻塞衛教手冊說出注意事項，並運用分解圖片正確自我執行肺復原運動，增強疾病自我管理。健康識能程度會影響疾病認知及衛教效果，建議若能在衛教前先評估健康識能程度，再依據其程度選擇合適的衛教方式與工具，將可提升治療計畫的遵從度及成效。

This article explores the application of health literacy concepts in caring for a 65-year-old male patient with pulmonary obstruction from August 28, 2020, to September 4, 2020. Employing a holistic nursing assessment framework, the study utilized physical assessments, communication techniques, interviews, and chart reviews to gather data and establish a therapeutic nurse-patient relationship. Major health issues identified included inefficient breathing patterns, anxiety, and ineffective self-health management. Nursing interventions focused on teaching pursed-lip breathing, relaxation techniques, and effective coughing to improve breathing efficiency. Active listening and empathy helped uncover the patient's anxiety triggers, particularly related to breath control. The patient was guided to use a selfassessment scale to monitor daily breathing and identify strategies to address breathlessness risk factors, leading to reduced hospitalization frequency and decreased anxiety over three months. Utilizing health literacy principles, the patient accessed visual aids depicting precautions for pulmonary obstruction and instructions for lung recovery exercises to enhance self-management skills. Recognizing the impact of health literacy on disease awareness and education outcomes, the study recommends pre-assessment of patients' health literacy levels to tailor education methods and tools accordingly, thereby optimizing treatment effectiveness.