一位遊民愛滋感染者合併肺部感染個案的護理經驗

A Nursing Experience of an HIV-Positive Homeless Person with Pulmonary Infection

10.6692/KJN-2013-30-2-9

溫宛虹(Wan-Hung Wen)；武香君(Shiau-Jiun Wu)；馮明珠(Ming-Chu Feng)

愛滋感染者 ； 遊民 ； 護理經驗 ； 肺部感染 ； HIV-positive individuals ； homeless people ； nursing experience ； pulmonary infection

高雄護理雜誌

30卷2期（2013 / 08 / 01）

95 - 105

繁體中文

愛滋感染者若能維護日常健康生活，將可減少因伺機性感染導致的反覆住院，但對居無定所的遊民而言，並非易事。本文藉由出院準備服務方式，協助一位遊民愛滋感染者獲得社會資源，進而提升自我照顧能力及疾病控制意願。筆者於2009年3月2－18日護理期間，以身、心、社會功能評估，確立其有活動無耐力、身體心像紊亂、知識缺失、個人因應能力失調等護理問題。經由提供呼吸照護、漸進式活動、皮膚照護，協助其發展正向身體心像，在護理指導方面除給予疾病控制及規則服藥的重要性及好處之相關知識外，亦運用藥盒、手機等方法提醒服藥方式，增加服藥遵從性，並以跨科室協調方式提供出院準備服務，聯繫相關機構緊急安置，滿足其生理及居住需求，給予心理支持，提升自我照顧意願。期許本文能讓護理人員重視愛滋病患出院準備的重要性，協助其運用社會資源及支持系統，達到最佳的疾病自我控制。

Maintaining a healthy lifestyle is very important for people living with HIV/AIDS to avoid repeated hospitalizations due to opportunistic infections, although this is unrealistic for homeless people. This case study described a nursing experience of helping an HIV-positive homeless person to improve self-care ability and increase willingness to control diseases by using discharge plans to obtain social resources. The author assessed the case's physical, mental and social functions, and identified major nursing problems including activity intolerance, body image disturbance, knowledge deficiency, and ineffective coping strategy from March 2-18, 2009. Through respiratory care, progressive activity and skin care, the client was able to develop a positive body image. In nursing care, it is important to provide the relevance and benefits of medication for knowledge of disease control, in tandem with use of the pillbox and mobile phone to increase medication adherence. Discharge plans were made by cross-department coordination to enable placement services to meet his housing needs. This case study serves as an example that emphasizes the importance of discharge planning for HIV-positive individuals and the value of using social resources and support systems to achieve optimal control on diseases.