照顧一位初次罹患急性心肌梗塞病人之加護經驗

An Intensive Care Nursing Experience of a Patient with First-Time Acute Myocardial Infarction

沈鎂吟(Mei-Yin Shen)；陳昱芬(Yu-Fen Chen)

急性心肌梗塞 ； 加護病房 ； 戒菸 ； acute myocardial infarction ； intensive care unit ； smoking cessation

志為護理-慈濟護理雜誌

18卷1期（2019 / 02 / 01）

126 - 136

繁體中文

本文為照顧一位47歲首次罹患急性心肌梗塞個案，於緊急接受心導管介入治療後入住加護病房，在加護病房期間提供疾病照護與強化戒菸動機、增強戒菸信心的護理經驗。筆者於2016年4月8日至4月11日護理期間，運用Gordon十一項健康功能評估，藉由觀察、會談、身體評估等方式確立個案主要健康問題有：知識缺失、焦慮及健康尋求行為（與戒菸有關）。運用5A戒菸輔導方法協助病人成功戒菸並透過正向、積極的健康行為，提升急性心肌梗塞病人居家自我照護能力。出院後電訪持續追蹤三個月，個案運用飲食控制及運動已減重五公斤且回到工作崗位，達到持續戒菸成果。

The article described the nursing experience of a 47-year-old male patient with first-time acute myocardial infarction, who was transferred to the ICU unit after undergoing percutaneous coronary intervention, and received disease-specific care and strengthened motivation and confidence for smoking cessation. The nursing period lasted from April 8 to 11, 2016, during which data were collected by means of observation, interview, medical records, and physical assessments. With Gordon's 11 functional health patterns as framework for holistic assessment, the result revealed that the patient had knowledge deficiency, anxiety and specific health seeking behavior. The 5A strategy for brief smoking cessation was applied to assist the patient with successful smoking cessation, and encouraged positive, active healthy behaviors to enhance the patient's self-care ability at home. A 3-month follow-up after discharge reveled that the patient lost 5 kg through diet control and exercise, is back at work, and did not smoke.

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