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題名:末期酒精性肝硬化病人之照護經驗
書刊名:榮總護理
作者:蘇盈如連靜雯溫明寰
作者(外文):Su, Ying-juLien, Ching-wenWen, Ming-huan
出版日期:2018
卷期:35:2
頁次:頁205-212
主題關鍵詞:酒精性肝硬化末期肝病腹水照護Alcoholic cirrhosisEnd-stage liver diseaseNursing care of ascites
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:2
  • 點閱點閱:3
本文描述一位49歲男性因長期飲酒導致酒精性肝硬化末期,因嚴重腹水、肝腎症候群等合併症,且面對只能等待屍肝機會的無望感之照護過程。照護期間為2017年8月15日至9月15日,筆者透過觀察、會談等技巧,收集病人身、心、靈各方面資料,以Gordon十一項健康功能型態工具評估確立健康問題,包括體液容積過量、身體心像紊亂、無望感等,並透過與病人建立良好護病關係,共同討論並擬定照護計畫、設定目標。期間提供腹腔放液、低塩、限水飲食計畫及改變烹調方式,密切監測體重變化等措施,改善身體不適;運用鼓勵表達自身感受,協助了解罹病事實,鼓勵家庭支持等,讓病人重拾信心,肯定自我價值;積極正向面對疾病延長壽命,以等待肝臟移植機會;筆者建議能編制慢性肝病個案管理師,對肝病病人照護能更加完整。
This paper describes the nursing care of a 49-year-old man with alcohol-induced cirrhosis. The patient was in the end stages of alcoholic cirrhosis with serious complications such as ascites and hepatorenal syndrome. The patient faced the psychological impact of waiting for a liver transplant as well as feelings of hopelessness. The period of care described herein was from August 15, 2017 to September 15, 2017. The authors collected information about the patients' physical, mental, and spiritual health through observation, interviews and other techniques. Assessed using Gordon's 11- item functional health assessment, the patient's health problems included excess fluid, disturbed body image, and hopelessness. During the care process, a relationship was established with the patient to discuss and mutually develop a care plan. The developed plan focused on problems of excess fluid management, and included nursing interventions for abdominal paracentesis, a low-salt diet, fluid restrictions, changes to cooking habits, and weight monitoring. To address the patient's disturbed body image and hopelessness, he was encouraged to express his feelings, to use his fellow patients for support, and to understand the facts of his illness with encouragement from his family. Using the developed care plan, the patient could try to regain his confidence by affirming his self-worth. Furthermore, the care plan provided the patient with a chance to extend his life expectancy while waiting for a liver transplant. Employing this form of care management for patients with chronic liver disease could help provide more complete nursing care.
期刊論文
1.詹淑雅、劉芹芳、金繼春(20110400)。身體心像紊亂之概念分析。新臺北護理期刊,13(1),63-72。  延伸查詢new window
2.徐雯娟、賀倫惠、林梅香、邱綉玲(20141000)。不同臥位對肝硬化腹水病人之血氧飽和度、舒適度與呼吸困難程度之影響。護理雜誌,61(5),66-74。new window  延伸查詢new window
3.Bahrami, M.、Mohamadirizi, M.、Mohamadirizi, S.、Hosseini, S. A.(2017)。Evaluation of body image in cancer patients and its association with clinical variables。Journal of Education and Health Promotion,6(81),S1-S5。  new window
4.Middleton , R. J.(2014)。Meeting the psychological care needs of patients with cancer。Nursing Standard,28(21),39-45。  new window
5.林婉如、黃惠滿、吳佩珊(20161200)。護理人員照護肝硬化病人之困難及挑戰。臺灣健康照顧研究學刊,17,127-142。  延伸查詢new window
6.Kumar, Manoj、Panda, Dipanjan(2014)。Role of supportive care for terminal stage hepatocellular carcinoma。Journal of Clinical and Experimental Hepatology,4(Suppl. 3),S130-S139。  new window
研究報告
1.衛生福利部。105年度死因統計。  延伸查詢new window
圖書
1.黃靜微、林家綾、喬佳宜、程子芸、林麗秋、郭惠敏、張秉宜(2016)。最新護理診斷手冊中文版。台北市:華杏。  延伸查詢new window
圖書論文
1.馮容芬、郭淑芬、林小玲(2014)。消化系統疾病與護理。新編內外科護理學。台北市:永大。  延伸查詢new window
 
 
 
 
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