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長庚護理

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篇名 一位罕見肌萎縮性側索硬化症患者之護理經驗
卷期 26:1=89
並列篇名 The Nursing Experience of a Rare Disease with Amyotrophic Lateral Sclerosis
作者 藍心妤黃煒淇蔡麗紅
頁次 066-076
關鍵字 罕見疾病肌萎縮性側索硬化症呼吸道清除功能失效體溫過高無望感rare diseaseamyotrophic lateral sclerosis ineffective airway clearancehyperthermiahopelessness
出刊日期 201503
DOI 10.3966/102673012015032601007

中文摘要

本文旨在描述一位肌萎縮性側索硬化症患者,面臨呼吸肌肉衰弱引發肺部合併症,所造成的生理及心理衝擊的護理經驗。護理期間自2013年4月16日至5月10日。在照護期間運用Roy適應模式為評估架構,確立個案有:「呼吸道清除功能失效」、「體溫過高」及「無望感」之健康問題。於護理過程中,筆者藉由陪伴、傾聽並鼓勵個案說出心裏的感受,另外強化社會支持系統及協助個案探索生命的意義,以肯定自己存在的價值;執行胸腔護理並教導腹式呼吸及手操作腹部推力的技巧,以增加痰液清除之功效;利用促進散熱的方法,以維持體溫的恆定,並提供發燒的個別性護理指導以增進個案的身體舒適。盼藉此經驗能提供護理人員作為日後在照顧類似病患之參考。

英文摘要

The case report described the nursing experience of caring a patient with amyotrophic lateral sclerosis (ALS) complicated with respiratory muscle weakness induced pulmonary complications. The nursing care duration was from April 16 to May 10, 2013. The Roy Adaptation Model was used as the assessment framework. The patient’s health problems were identified as follows: ineffective airway clearance, hyperthermia, and hopelessness. The author encouraged the patient to express his feelings and concerns in order to solve the patient’s nursing problems. The author also enhanced the patient’s social support system and assisted the patient in exploring the meaning of his life and validating the value of his existence. In addition, the nursing interventions included providing chest physical care, teaching deep breath skill, and performing manual abdominal thrust to improve sputum cleaning, and providing fever nursing care to improve comfort level. The individual nursing interventions in this article could serve as a reference for caring ALS patients in the future.

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