照護一位新冠肺炎病人之護理經驗

A Nursing Experience of Caring a Patient with Coronavirus Disease

10.6386/CGN.202109_32(3).0012

陳姚向(Yao-Hsiang Chen)；胡曉玲(Hsiao-Ling Hu)；王美珍(Mei-Chen Wang)；林佳慧(Chia-Huei Lin)

新型冠狀病毒肺炎 ； 味嗅覺障礙 ； 焦慮 ； 護理 ； Coronavirus disease 2019 ； taste and smell disorders ； anxiety ； nursing

長庚護理

32卷3期（2021 / 09 / 01）

141 - 151

繁體中文

本文為描述一位確診新冠肺炎且入住負壓隔離病房接受治療的病人，因面對未知新興傳染病且接受隔離而產生身、心各方面衝擊的護理經驗。照護期間筆者藉由身體評估、觀察及訪談等方式收集資料，運用Gordon十一項功能性健康型態進行系統性評估，確立個案健康問題包含：「體溫過高」、「感覺及知覺紊亂」及「焦慮」等，並擬定個別性護理計畫，除依醫囑執行醫療處置緩解個案生理不適外，亦發揮護理的獨立功能，提供氣味明顯的食物以促進食慾；另運用手機通訊軟體及電話進行個別會談，持續提供心理支持及協助抒發情緒與瞭解病程變化、減緩個案因罹患新興傳染疾病所面對之未知及承受的身心衝擊，最終個案症狀改善及採檢轉陰後出院，筆者考量因應此新興傳染病尚無明確照護指引，故期望將此經驗分享給臨床護理人員照護類案之參考。

This article described the nursing experience of caring a patient with coronavirus disease facing physical and mental impacts due to unknown emerging infectious diseases and being isolated. During the nursing period, data were collected via interviewing and physical assessment. Health problems, identified through the assessment tool of Gordon 11 Functional Health Patterns, included: (1) hyperthermia, (2) disturbances in sensory and perception, and (3) anxiety. Individualized nursing care plans were then developed. In addition to medical treatment, the primary nurse provided food with apparent smell to promote the patient's appetite and used both of the communication software of mobile phone and telephone to provide mental support to help the patient to express emotions and recognize the progress of the illness, and alleviated his physical and mental impacts due to the emerging infectious diseases. The patient finally recovered and was discharged. Since the treatment strategy and caring guidelines of this new infectious disease remain unclear, we anticipate that the experience of this article provides clinical practitioners with a reference for caring similar patients.

1. 汪郁馨, Y.,黃淑芬,S .,陳素惠, S.,李麗紅, Li.(2018)。照顧一位初次罹患肺結核服藥不遵從患者之護理經驗。彰化護理，25(2)，67-78。
   連結：
2. 許藏菁, T.,吳佳鉛, C.,賴霈妤, P.,薛伶珊, L.,賴怡因, Y.,柯乃熒, N.(2020)。顧一位 COVID-19 病人在隔離期間之護理經驗。護理雜誌，67(3)，111-119。
   連結：
3. Caliendo, A. M., & Hanson, K. E. (2020). Coronavirus disease 2019 (COVID-19): Diagnosis. UpToDate. Retrieved Jun 19, 2020, from https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-diagnosis
4. Elkin, M. SV.,& Cucchiara, B. L,& Koralnik, I. J. (2020). Coronavirus disease 2019 (COVID-19): Neurologic complications and management of neurologic conditions. UpToDate. Retrieved Jul 09, 2020, fromhttps://www.uptodate.com/contents/coronavirus-disease -2019-covid-19-neurologic-complications-and-management-of-neurologic-conditions
5. Kim, A. Y., & Gandhi,R. T.(2020). Coronavirus disease 2019(COVID-19): Management in hospitalized adults. UpToDate. Retrieved Jun 26, 2020,fromhttps://www.uptodate.com/contents/ coronavirus-disease-2019-covid-19-management-in-hospitalized-adults
6. McIntosh, K. (2020). Coronavirus disease 2019 (COVID-19): Epidemiology, virology, and prevention. UpToDate. Retrieved Jul 13, 2020, from https://www.uptodate.com/contents/coronavirus -disease-2019-covid-19-epidemiology-virology-and-prevention
7. Mikkelsen, M. E., & Abramoff, B. (2021). Coronavirus disease 2019 (COVID-19): Evaluation and management of adults following acute viral illness. UpToDate. Retrieved Jan 25, 2021, from https://www.uptodate.com/contents/contents/coronavirusdisease-2019-covid-19-evaluation-andmanagement-of-adults-following-acute-viral-illness
8. Shi, Y.,Wang, G.,Cai, X.,Deng, J.,Zheng, L.,Zhu, H.,Zheng, M.,Yang, B.,Chen, Z.(2020).An overview of COVID-19.Journal of Zhejiang University Science B,21(5),343-360.
9. 王子胤, T.,王筱珮,, S.(2003)。照顧一位SARS患者之護理經驗。護理雜誌，50(6)，87-93。
10. 衛生福利部疾病管制署 (2020a，4 月 16 日 )‧醫療機構因應 COVID-19( 武漢肺炎 ) 感染管制措施指引。[Taiwan Centers for Disease Control. (2020a, April 16). Clinical guidelines for infection control of COVID-19 in health care settings. Retrieved from https://www.cdc.gov.tw/ Category/ListContent/NO6oWHDwvVfwb2sbWzvHWQ?uaid=UDXo5Wd2jDnm__vJUU9PjQ]
11. 衛生福利部疾病管制署 (2020b，6 月 17 日 )‧新型冠狀病毒 (SARS-CoV-2) 感染臨床處置暫行指引第七版。[Taiwan Centers for Disease Control. (2020b, June 17). Clinical guidelines for the management of SARS-CoV-2(7th ed.). Retrieved from https://www.cdc.gov.tw/Category/Page/xCSwc5oznwcqunujPc-qmQ]