探討嚴重急性呼吸道症候群患者之照護情形及需要

A Study of Health Care and Needs for SARS Patients

10.6142/VGHN.22.3.269

余錦秀(Chin-Hsiu Yu)；周惠千(Hui-Chien Chou)；林妙璦(Miaw-I Lin)

嚴重急性呼吸道症候群 ； 健康照護需要 ； SARS Severe Acute Respiratory Syndrome ； health care needs

榮總護理

22卷3期（2005 / 09 / 01）

269 - 280

繁體中文

本研究目的：一、瞭解某醫學中心嚴重急性呼吸道症候群（以下簡稱SARS）通報患者人口學及疾病分佈；二、SARS通報患者處置項目及健康問題；三、SARS患者返家後適應及照護需要。研究樣本爲南部某醫學中心隔離病房SARS通報病例共58例，方法是以回溯性檔案分析爲主，檔案來源爲病歷，電話訪問爲輔。由三位資深護理人員調閱病歷並進行內容分析。結果顯示患者以男性居多63.8%；平均54.6歲；感染來源不明者41.4%；平均住院9.28天；出院時診斷爲SARS最多31.0%，次爲肺炎29.3%；死亡率19.0%；出院動態以門診追蹤最多74.1％。入院症狀前三名爲發燒、X光呈現肺炎、喀痰；主要護理問題前三名依序爲體溫過高、呼吸道清除功能失效、低效性呼吸型態；藥物使用以抗生素最多。返家後仍覺呼吸喘87%，家人的態度100%接納，25%受朋友、鄰居排斥。建議採取敏感度、精確度較高之篩檢工具，以及早確定診斷及隔離。患者於出院計劃中應特別強調有關肺部複健運動及個案管理，持續臉瓖與追蹤，以提供必要的醫療及心理輔導。

The purpose of this study was (1) to describe demographics, and geographic distribution of reported SARS patients; (2) to understand treatment items and health problems; (3) to survey the coping status and health care needs after discharge. This retrospective study sampled fifty-eight reported cases. A chart review was implemented, using a standard recognized by three senior nursing staffs. The results revealed that the male gender was 63.8%; the mean age 54.6 years old; the unknown infection source 41.4%; the mean admission day 9.28 days. The discharge diagnosis showed: SARS 31.0%; pneumonia 29.3%; followed by death 19.0%. The first three symptoms and signs were fever, pneumonia patch on X-ray film, and sputum. The first three nursing problems were hyperthermia, impaired function of airway clearance, and ineffective respiratory pattern. 87% of patients were short of breath after returning home, 100% experienced acceptance for family attitude, and 25% experienced rejection by friends and neighbors. The study suggests to use higher sensitivity screen tools, to isolate appropriately, and to emphasize pulmonary rehabilitation exercise.