照顧一位失能毒癮愛滋感染者之護理經驗

A Nursing Experience of a Disabled HIV-Positive Drug-Addicted Patient

毒癮愛滋感染者因毒癮與愛滋病的雙重被歧視身分，臨床人員在照顧此類個案常會面臨家人放棄照顧、無機構收容的窘境。本文描述照護一位長期臥床的毒癮愛滋患者之護理經驗，護理期間為2013年6月13日至8月30日，藉由觀察、訪談及運用生、心、靈及社會層面評估，確立皮膚完整性受損、無望感及社會支持功能不足等健康問題。筆者運用同理心、關懷及陪伴，鼓勵其表達內心恐懼及感受，協同跨團隊人員，適時提供生理照顧、情緒支持及尋求社會資源，最終順利完成機構安置，使個案以正向態度面對自我。由於國內收置愛滋失能者的機構欠缺，在資源匱乏情況下，筆者仍積極協助且能成功解決後續安置問題，期望藉此護理經驗，作為日後照護此類病患之參考。

When caring for HIV-positive drug-addicted patients, clinical nurses frequently encounter problems such as lack of care from family members and lack of treatment facilities due to the double discrimination such patients face. This paper describes the nursing experience of a prolonged bed rest, HIV-positive drug-addicted patient. During the nursing period from June 13 to August 30 in 2013, data were collected through observations and interviews as well as physiological, psychological, spiritual, and social assessments. The health problems included impaired skin integrity, hopelessness, and insufficient social support functioning. We not only encouraged the patient to express inner fear and feelings using nursing skills including empathy, attention, and presence but provided physical care, emotional support, and access to social resources through interprofessional collaborative practice as well, thereby facilitating the success of residential placement and helping the patient develop a positive attitude toward self. Despite inadequate treatment facilities and insufficient resources for disabled HIV-positive patients, we proactively assisted the patient in solving subsequent placement problems. This nursing experience could serve as a reference in caring for such patients.