| 英文摘要 |
We reported a case of recurrent secondary spontaneous pneumonthrax (S. S. P) with repetitive delirium. The patient was a 73 year-old man, suffering from episodes of breathing difficulty, hypoxemia and anxiety, and even developing spontaneous subcutaneous emphysema. He received eight pleurodesis therapies to prevent recurrence of SSP and two transthoracic endoscopic surgeries to remove the collapsed ineffective alveolus. The complete nursing care was done by a targeted team, including physical assessment, interview, and consisted of medical physicians, a nutritional consultant, and social workers. Roy’s adaptation model was applied to assess and disclose the health problems, including ineffective breathing style, acute confusion, inadequate nutrition, high risk of infection, sleep disturbance, activity intolerance, caregiver role strain and altered family processes. Subsequently, massage and touch relaxation techniques were performed, and a safe and comfortable environment was arranged to improve sleep quality in the acute confusion stage. Provision of cognitive reality therapy was also offered. In addition, he was directed to perform pulmonary rehabilitation exercises, and encouraged to inhale a spirometer hour by hour. He was given sufficient listening, attention, repetitive individualized interviews, sincere care, and instruction in adequate health information for respiratory care. After repeated admission and discharge several times, the patient and family then understood the necessity of a strengthened illness cognition. The family organized nursing for individualized care and learned how to utilize the social resources to face their problems. We, therefore, believe a comprehensive health-care management and service care really help in the care of patients with recurrent SSP. |
