一位後天免疫缺乏症候群經產婦之照護經驗

Nursing Experience of a Multiparous Woman with Acquired Immunodeficiency Syndrome

10.29494/LN.202306_24(2).0009

陳宛柔(Wan-Rou Chen)；張怡惠(Yi-Hui Chang)

後天免疫缺乏症候群 ； 母子垂直感染 ； 焦慮 ； Acquired Immunodeficiency Syndrome ； vertical infection ； anxiety

領導護理

24卷2期（2023 / 06 / 01）

117 - 129

繁體中文;英文

本文描述一位罹患後天免疫缺乏症候群之產婦，入院剖腹產之照護經驗，現已育有兩女皆排除感染，但身為長媳需肩負傳宗接代壓力，經討論後決定再生第三胎，但患有愛滋疾病除先生知情外，尚未告知其他家人。因此除了焦慮新生兒健康狀況外，也擔心醫療人員是否會意外透露造成疾病曝光。照護期間為2019年2月22日至2019年2月27日，運用Gordon十一項健康功能性評估，發現個案有：潛在危險性感染、急性疼痛及焦慮的健康問題，護理過程中表達關心並建立護病關係，在評估身體復舊過程時，加強衛教說明，持續觀察傷口有無感染症狀、提供疼痛緩解方式、維護其隱私避免病情曝光，傾聽並引導說出心中焦慮及壓力，對新生兒照護有疑慮時，安排與新生兒病房護理人員約定時間，可諮詢嬰兒返家後用藥狀況，減少對於新生兒健康憂慮。另為減緩照護者壓力，建議醫院可專為愛滋家庭設置照護專線，提供照護者更多對愛滋病新生兒之相關持續性照護、知識及因應等措施。希望透過分享此篇特殊產婦之照顧經驗，提供日後同仁臨床照護之參考。

This article describes the nursing experience of a multiparous woman with AIDS, suffering from Acquired Immunodeficiency Syndrome, admitted to the hospital for a caesarean section. The case already had two daughters who were not infected with AIDS, but as the eldest daughter-in-law, she was under the pressure of bearing a son for succession. After discussion, she decided to have a third child. Apart from her husband, she has not informed other family members about her AIDS condition. Apart from being anxious about the health of the newborn during the hospitalization, the case was also concerned in regards to medical staff who may accidentally reveal her disease to others. The nursing period was from February 22 to 27, 2019. Using the Gordon Eleven Functional Health Pattern Assessment, it was found that the case shown: potentially dangerous infection, acute pain, and anxiety health issues. During the nursing period, we expressed empathy and established the relationship with the patient, strengthened health education when evaluating the process of physical recovery; continuously observed wounds for any signs of infection, provided pain relief methods, maintained the case’s privacy to avoid disclosure of the disease, listen and guide her to express her anxiety and stress. When she had concerns about caring of the newborn, arrange appointments with the nurses in the neonatal ward so she can consult about the baby's medication status after returning home, that also reduced her worries about the health of the newborn. Furthermore, in order to relieve the pressure of the caregiver, we recommended that the hospital set up a hotline for AIDS families, provide those caregivers with more continuous care, knowledge and intervention measures for newborns with AIDS. Hopefully by sharing the care experience of this special parturient, it will provide a reference for colleagues in clinical care in the future.

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