協助一位重症肌無力併呼吸衰竭病患返家照護之護理經驗

Nursing experience of a myasthenia gravis with respiratory failure patient returned home

本篇為協助一位重症肌無力併呼吸衰竭病患返家照護之護理經驗，於104年8月2日至104年8月24日護理期間，筆者依據Gorden十一項功能性健康型態進行評估，歸納出主要護理問題有：1.低效性呼吸型態，2.活動無耐力，3.無望感，4.照顧者角色緊張。筆者設計個別性護理計畫，提供個案適當的護理措施，如背部叩擊、姿位引流、肌力訓練等，改善肺部發炎及預防肌肉萎縮；運用同理心及主動關懷，鼓勵個案正向思考，澄清生命價值觀，引導正向情緒並提供抒發管道。經由實施上述護理措施後，個案從被動、沮喪、無望情緒，漸漸能與筆者討論內心的掙扎，最後能重視生命的意義且勇於面對疾病。筆者亦針對主要照顧者教導居家照顧技能，適時提供所需資訊及後續追蹤，減輕照護顧者的心理壓力，使個案出院後也能獲得完整性及連續性的照護，家庭運作功能正常，並提升整體生活品質。

This article described nursing experience of a myasthenia gravis with respiratory failure patient returned to home. Caring period was from August 8th, 2015 to August 24th, 2015. Health related problem of this case included ineffective breathing pattern, activity intolerance, hopelessness, and the caregiver's role strain. The medical team designed individual nursing plan to cure pulmonary inflammation and prevent muscle atrophy. Then helped the case to creat correct perception of the disease and empathized and encouraged him. Finally instructed primary caregiver caring skills to relieve family psychological stress. The case obtained integrity and continuity care and family can upgrade quality of life after discharge.