照顧一位急性淋巴性白血病確診COVID-19病人之加護經驗

Ching-Wen CHENG

doi:10.6224/JN.202302_70(1).14

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P101 - 109

医药卫生 > 预防保健与卫生学
医药卫生 > 社会医学

DOI： 10.6224/JN

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照顾一位急性淋巴性白血病确诊COVID-19病人之加护经验

Experience Caring for an Acute Lymphoblastic Leukemia Patient With COVID-19 in the ICU

郑净文(Ching-Wen CHENG)

护理杂志； 70 卷 1 期 (2023 / 02 / 01) ， P101 - 109

英文 DOI： 10.6224/JN.202302_70(1).14

COVID-19 ；急性淋巴性白血病；加护经验； COVID-19 ； acute lymphoblastic leukemia ； intensive care experience

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摘要 │ 参考文献 (26) │ 被引用文献 (1) │ 国际计量

摘要〈TOP〉

并列摘要〈TOP〉

This article describes the author's experience providing care in the ICU to a patient with acute lymphoblastic leukemia who had contracted COVID-19. The period of care spanned from June 29 to July 12, 2021. Data were collected during direct care, observations, and interviews and using medical record reviews. During the course of care, supportive care, bundle care, and other infection control measures were provided. The patient was monitored and tracked regularly for infection-related indicators, which successfully mitigated the impact of the infection and prevented secondary bacterial infections. Respiratory care measures such as assistance with Q3H awake prone positioning on the bed were provided. Also, the safety and smoothness of the ventilator pipeline and catheter when prone were confirmed and the setting of the ventilator was adjusted based on the blood oxygen concentration and gas analysis. These measures improved the patient's oxygenation, allowing their successful removal from the ventilator. Delayed chemotherapy affects the survival rate of patients with acute lymphoblastic leukemia as well as improves their physical and emotional status. Using patient-centered communication skills, empathizing with the patient's negative feelings, encouraging and assisting their participation in self-care, and helping facilitate prescribed hematologist-oncologist care, the author helped increase the patient's perceived self-control and positive attitudes and effectively alleviated their hopelessness regarding their current situation. Several recommendations arise from this care experience. Social media apps may be used to create virtual support groups for patients comprising significant relatives and friends to better support patients in quarantine. Also, a health education brochure addressing the latest COVID-19 disease, treatment, and care information may be given to patients with COVID-19 upon hospital admission to reduce their uncertainties and improve their self-care awareness to maximize their ability to successfully navigate the long quarantine treatment process.

参考文献 ( 26 ) 〈TOP〉

林采榆, T.-Y.,柯信国, H.-K.(2022)。胸腔病例（三八四）新型冠状病毒肺炎（COVID-19）重症照护及呼吸器脱离。临床医学月刊，89(1)，59-63。
连结：
Alvarnas, J. C.,Brown, P. A.,Aoun, P.,Ballen, K. K.,Barta, S. K.,Borate, U.,Boyer, M. W.,Burke, P. W.,Cassaday, R.,Castro, J. E.,Coccia, P. F.,Coutre, S. E.,Damon, L. E.,DeAngelo, D. J.,Douer, D.,Frankfurt, O.,Greer, J. P.,Johnson, R. A.,Kantarjian, H. M.,Smith, C.(2015).Acute lymphoblastic leukemia, version 2.2015.Journal of the National Comprehensive Cancer Network,13(10),1240-1279.
Centers for Disease Control and Prevention. (2020). Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19). https://search.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/ppcovidwho-2607
Cohen, D.,Wasserstrum, Y.,Segev, A.,Avaky, C.,Negru, L.,Turpashvili, N.,Anani, S.,Zilber, E.,Lasman, N.,Athamna, A.,Segal, O.,Shenhav-Saltzman, G.,Segal, G.(2020).Beneficial effect of awake prone position in hypoxaemic patients with COVID-19: Case reports and literature review.Internal Medicine Journal,50(8),997-1000.
Curigliano, G.,Banerjee, S.,Cervantes, A.,Garassino, M. C.,Garrido, P.,Girard, N.,Haanen, J.,Jordan, K.,Lordick, F.,Machiels, J. P.,Michielin, O.,Peters, S.,Tabernero, J.,Douillard, J. Y., Pentheroudakis, G.(2020).Managing cancer patients during the COVID-19 pandemic: An ESMO multidisciplinary expert consensus.Annals of Oncology,31(10),1320-1335.

被引用文献 ( 1 ) 〈TOP〉

(2024)。一位裘馨氏肌肉萎缩症青年初次呼吸衰竭之照护经验。荣总护理，41(3)，286-294。

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