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題名:照顧一位慢性阻塞性肺疾病合併結腸腫瘤手術病人之護理經驗
書刊名:長庚護理
作者:蔡慧于巫怡翎曾斐琳
作者(外文):Tsai, Hui-yuWu, Yi-lingTseng, Fei-lin
出版日期:2015
卷期:26:3=91
頁次:頁338-347
主題關鍵詞:慢性阻塞性肺病呼吸衰竭照顧者角色緊張Chronic obstructive pulmonary diseaseRespiratory failureCaregiver role strain
原始連結:連回原系統網址new window
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  • 共同引用共同引用:37
  • 點閱點閱:144
本文主要為描述一位慢性阻塞性肺疾病合併呼吸衰竭的病人,在住院期間意外發現有結腸腫瘤並接受手術,於病情穩定後由加護病房轉出至病房之護理經驗。護理期間自2012年9月15至9月23日,因個案疾病所帶來的失能且個案病況未穩定,照顧者倍感照護壓力而產生緊張、焦慮等問題,透過Gordon十一項健康功能評估發現,個案除了因疾病造成的呼吸道清除功能失效及營養少於身體需要問題外,明顯有照顧者緊張之問題出現。經由筆者計畫性護理,其呼吸道痰液能得已排出,並每日執行胸腔復健運動以維持肺功能,漸進式恢復經由管灌來提供足夠以維持身體所需的營養,並透過與家屬共同擬定計畫,使家屬對個案的照顧有參與感,減少對照顧技術的焦慮,進而維持良好的照顧品質,藉以提供臨床人員照護此類個案之參考。
This article describes the nursing experience of a chronic obstructive pulmonary disease (COPD) with respiratory failure patient receiving a colonic surgery when discovered accidentally of colon tumor during hospitalization; the patient was then transferred out of the intensive care unit (ICU) after stabilization. During the caring period, from September 15th to September 23rd, 2012, caregiver demonstrated symptoms of stress and anxiety due to the disability and unstable condition of the patient. The author applied Gordon's 11 Functional Health Patterns Assessment to identify the primary problems of this case and discovered that apart from illness-related problems such as ineffective airway clearance and altered nutrition (less than body requirements), the mental strains of the caregiver role have also became an issue. Through nursing care interventions, the author assisted and trained the patient to clear mucus in the respiratory tract himself, develop exercise training in pulmonary rehabilitation in sustaining lung function, and gradually improve the nutritional status of patient by using tube feeding. By discussing a care plan with patient's family, the caregiver was educated care techniques to ease caregiver's strain and anxiety, and gently developed a sense of involvement and continuously maintained a high quality of care. We would like to share the care experience as a reference for the nursing staff who encounter similar difficulties in the future.
期刊論文
1.陳慧雯、李雅欣、王桂芸(20111000)。慢性阻塞性肺疾病病人「低效性呼吸型態」之護理。護理雜誌,58(5),95-100。new window  延伸查詢new window
2.裘苕莙、徐月霜(20060300)。建立慢性阻塞性肺疾病急診出院病患護理指導模式之專案。榮總護理,23(1),79-86。new window  延伸查詢new window
3.許正園、辛幸珍(20110300)。非癌疾病的安寧療護:談COPD末期照護倫理。臺灣醫學,15(2),180-186。  延伸查詢new window
4.呂舒容、何秀玉(20110900)。一位腦中風病患及其主要照顧者之護理經驗。長庚護理,22(3)=75,411-420。new window  延伸查詢new window
5.林韋君、黃秀梨(20100400)。應用紐曼模式於一位慢性阻塞性肺疾病患者之護理經驗。領導護理,11(1),63-76。  延伸查詢new window
6.林詩淳、蔡坤維、江瑞坤、范國聖(20080200)。老年人的肺炎預防及護理。志為護理,7(1),65-70。  延伸查詢new window
7.洪珮雯、丁肇鳳、游麗惠、周繡玲(20050600)。照護一位老年病患面對結腸造口之護理經驗。腫瘤護理雜誌,5(1),69-81。  延伸查詢new window
8.郭明隆、顏兆熊(20100400)。慢性阻塞性肺病的治療。家庭醫學與基層醫療,25(4),130-136。  延伸查詢new window
9.詹佩芬、賴甫誌、姚文真、李淑蘭(20090700)。慢性阻塞性肺疾病患適應非侵襲性正壓呼吸器之護理經驗。澄清醫護管理雜誌,5(3),45-55。  延伸查詢new window
10.魏麗書、陳淑卿、吳淑貞(20081200)。一位初次診斷直腸癌病患手術後的護理經驗。長庚護理,19(4)=64,551-560。new window  延伸查詢new window
11.何宜蓁、徐菊容(20080400)。協助一位無望感老人成功移除尿管之居家護理經驗。長期照護雜誌,12(1),91-103。  延伸查詢new window
12.梁金銅(2006)。大腸直腸癌。台灣醫學,10(4),488-492。  延伸查詢new window
13.Rabe, K. F.、Hurd, S.、Anzueto, A.、Barnes, P. J.、Buist, S. A.、Calverley, P.、Zielinski, J.(2007)。Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease。American Journal of Respiratory Critical Care Medicine,176(6),532-555。  new window
14.O'Hara, R. E.、Hull, J. G.、Lyons, K. D.、Bakitas, M.、Hegel, M. T.、Li, Z.、Ahles, T. A.(2010)。Impact on caregiver burden of a patient-focused palliative care intervention for patients with advanced cancer。Palliative and Supportive Care,8(4),395-404。  new window
15.楊嘉玲、孫惠玲(20030500)。「照顧者負荷」概念分析。馬偕護理專科學校學報,3,15-27。  延伸查詢new window
16.邱啟潤、許淑敏、吳淑如(20030100)。居家照護病患之主要照顧者綜合性需求調查。醫護科技學刊,5(1),12-25。new window  延伸查詢new window
其他
1.衛生福利部(20130604)。民國101年主要死因分析,http://www.mohw.gov.tw/cht/DOS/DisplayStatisticFile.aspx?d=13689&s=1。  延伸查詢new window
 
 
 
 
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