照護一位脊髓星形細胞瘤併發急性呼吸衰竭病人預立醫療決策之護理經驗

Nursing Experience in Patient Care and Autonomous Advance Decision Making With a Patient of Spinal Astrocytoma Complicated With Acute Respiratory Failure

李慧玲(Hui-Ling Lee)；吳春桂(Chun-Kuei Wu)

急性呼吸衰竭 ； 焦慮 ； 照顧者負荷 ； acute respiratory failure ； anxiety ； caregiver burden

志為護理-慈濟護理雜誌

21卷2期（2022 / 04 / 01）

111 - 120

繁體中文

本文描述脊髓星形細胞瘤併發急性呼吸衰竭病人，面對病情危急時的恐懼與預立醫療決策之焦慮及案母對於病情變化引發照護緊張的護理經驗。護理期間2018/11/21～11/29，以Gordon十一項健康功能型態進行護理評估。健康問題：氣體交換障礙、焦慮、照顧者角色緊張。護理措施：跨團隊合作照護及呼吸器脫離訓練計畫，發展照護技術步驟圖示卡以手機錄影方式教導照護技巧，鼓勵參予治療計畫澄清疑問緩解心理壓力提升生活品質。建議臨床複雜情境及不符合重大疾病健保給付或長照2.0補助範圍者，利用院內社工資源或社會福利團體補助減輕經濟或照顧負擔。

This article describes my personal nursing experience in taking care of a patient with spinal astrocytoma, complicated with acute respiratory failure. During the nursing period from November 21st 2018 to November 29th 2018, we used Gordon's 11 Health Function Patterns for holistic nursing evaluation. The health problems included gas exchange disorder that contributed to the caregiver's anxiety. The measures we used this address this problem included collaboration across functional teams and protocoling a weaning strategy for respiratory training. We also introduced graphic cards and mobile phone-recorded teaching videos of nursing care to the caregiver. We strongly encouraged the patient to participate in his own treatment plan in order to clarify any doubts andquestions and to relieve psychological pressure to improve quality of life. We also suggest that resources from hospital socialwork and non-governmental welfare organizations can be utilized by patients who have complex clinical conditions and do not meet qualifications of national health insurance or Long-term Care 2.0.

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