運用音樂聆聽於心肌梗塞病人成功脫離呼吸器之護理經驗

The Use of Music in Myocardial Infarction Patients from Nursing Experience Respirator's Success

本文係探討一位心肌梗塞合併呼吸衰竭，於住院期間經歷多次呼吸器脫離失敗引發的生、心理問題。於2013年9月9日至24日照護期間運用Gordon十一項健康功能評估病人有呼吸道清 除功能失效、呼吸機戒斷反應功能失常、焦慮等健康問題。針對這些問題提供個別性護理，首先向病人說明呼吸訓練之進展及後續治療計畫，運用胸部復健運動及物理治療以增加呼吸肌耐受力、維持呼吸道通暢，其次引導病人表達其內心擔憂的事，連結家庭關懷及專業醫療團隊給予正向心理支持及鼓勵，以增強病人的信心，再藉由音樂聆聽減緩病人焦慮的情緒，幫助病人成功脫離呼吸器達到全人護理之目標；此照護經驗將有助提升護理專業照護品質及爾後同仁運 用音樂聆聽於臨床照護之參考。

This article explores a myocardial infarction complicated with respiratory failure experienced several times via ventilator failures leading to the health and psychological problems during hospitalization. Gordon’s 11 health functions were applied from September 9 to 24, 2013 in evaluation of patients with respiratory protection sunshine clearance failure, ventilator withdrawal reactions dysfunction, anxiety and other health problems. For these problems, individual nursing was provided. Firstly, explanation to the patient was given about breathing training progress and follow-up treatment plan, using chest physical therapy and rehabilitation exercise to increase respiratory muscle endurance, maintain airway. Secondly, patient was helped to express his/her inner fears, and follow-up was combined with family support and the professional medical team giving positive support and encouragement to increase the patient’s confidence, then music therapy was applied to slow down the emotions of anxiety and support the patient’s success from respirator to holistic nursing goals. This experience will assist to enhance nursing care quality and colleagues use of music in clinical care thereafter as a reference.