本文為一位氣喘青少年個案,自行停藥導致氣喘反覆發作造成呼吸困難及擔憂 疾病預後難以回歸日常生活之護理過程。護理期間自 2017 年 12 月 30 日至 2018 年 1 月 4 日,運用 Gordon 十一項功能性評估歸納健康問題有:低效性呼吸型態、 焦慮、無效性健康維護能力,筆者依個案認知發展教導肺復原呼吸運動,峰速值由 180L/min 進步到 380L/min;主動提供疾病資訊並介紹年紀相仿病友交流增強個案 的認知與信心,能減輕焦慮參與治療計劃擬定目標;利用手機健康管理應用程式教 導尖峰流速計自我監測,促使個案將自我照護落實於日常,達到良好的疾病自我管 理。建議以不批判、傾聽個案未執行自我照顧原因,達到有效溝通互動,提供個別 化健康教材,持續執行自我照護活動,以維持良好生活品質。

This is a case study of a nursing course for an asthmatic adolescent. The patient opted to discontinue medication so frequent asthma relapses that caused breathing difficulty developed, with little hope of regression. From December 30, 2017 to January 4, 2018, the patient’s eleven functional assessments were used to determine health problems: inefficient breathing patterns, anxiety and ineffec-tive health maintenance.

In accordance with the patient’s cognitive development, the nurse admin- istered lung rejuvenation respiratory exercise and the peak expiratory flow rate increased from 180L/min to 380L/min. Information about the condition was provided and other patients of the same age communicated with the patient to increase confidence and recognition. This reduced anxiety during the treatment plan when a mobile health management app was used for self-monitoring the peak flow meter so the patient was able to care for himself well.

This study finds that criticism is not constructive and concerns about self- care are addressed by effective communication and interaction. Individualized health teaching materials are necessary to ensure good self-care and quality of life.