照護一位新生兒紅斑狼瘡足月兒及其主要照護者之護理經驗

A Nursing Care Experience of a Full-term NewBorn with Systemic Lupus Erythematosus

本文主要探討一位新生兒紅斑狼瘡足月兒及其主要照護者的護理經驗。筆者自2019年8月3日至2019年8月20日擔任主護護理師期間，運用羅氏適應模式為整體性評估，藉由觀察、會談、身體評估，收集資料並加以分析整理，確立個案有體溫過高、皮膚完整性受損、照顧者角色緊張的護理問題。針對個案因新生兒紅斑狼瘡症候群所引起的皮膚紅疹、體溫過高給予個別性的護理措施；而對於案父母則是運用陪伴、傾聽技巧，主動了解其壓力源，且透過團體日常照護課程，親自示範教導日常照護的知識與技巧，並於課後回覆示教確認主要照護者的學習成效，藉由衛教照顧新生兒紅斑狼瘡症候群注意事項，確實提升案父母照護信心，使其及早適應父母角色，亦讓個案出院後也能得到完善照護。針對照護此類個案護理，建議可製作衛教指導單張及制定照護準則，且能舉辦相關課程，以提昇護理人員對該疾病的專業知識，使醫護人員能確實提供主要照護者適切的護理措施及照護指導，並藉此護理經驗分享，提供臨床護理人員在照顧新生兒紅斑狼瘡個案之參考。

This study described a nursing care experience of a full-term newborn with Systemic Lupus Erythematosus from August 3 to 20, 2019. The Roy's Adaptation Model, observation, interviews and physical evaluation were used to collect data. After data analysis, hyperthermia, impaired skin integrity and role strain of the caregiver were identified. Individualized caring procedures were provided regarding hyperthermia and skin rashes due to Systemic Lupus Erythematosus. The author accompanied and listened to the parents to recognize the source of stress. Group daily care training courses were provided for the parents, and teach-back was required to confirm the learning effectiveness. Health education on Systemic Lupus Erythematosus was given to increase the confidence of caregivers, so the client was able to receive a comprehensive care after discharge. It is suggested that health education leaflet and caring guideline can be established. Related courses can be hold to enhance the professional knowledge of nursing professionals, so they are able to provide appropriate nursing procedures and instructions. It is expected that this study provided a reference for those who work with newborns with Systemic Lupus Erythematosus.