照護一位愛滋病感染者併發伺機性感染行人工造口術後之護理經驗

Nursing Experience in Caring for an AIDS Case With Cytomegalovirus Enteritis Undergoing Enterostomy

林良餘(Liang-Yu Lin)；洪富如(Fu-Ju Hung)；林資諺(Zi-Yan Lin)

愛滋病 ； 肺囊蟲肺炎 ； 巨細胞病毒腸炎 ； 腸造口 ； AIDS ； cytomegalovirus enteritis ； enterostomy ； pneumocystis pneumonia

志為護理-慈濟護理雜誌

22卷6期（2023 / 12 / 01）

99 - 109

繁體中文;英文

本文描述一位愛滋病病人因害怕受歧視，而無規則追蹤治療，以至併發肺囊蟲肺炎及巨細胞病毒腸炎，疾病進展執行人工腸造口術，身體心像改變，以致焦慮產生，促使筆者之動機。於2021年6月18日至7月13日，藉由直接照顧、觀察、互動方式收集資料，運用Gordon十一項健康功能型態評估，發現「活動無耐力」、「身體心像功能紊亂」及「焦慮」等健康問題。照護期間運用跨團隊間合作照護，藉由復健改善活動耐力，以運動自覺量表，提供病人了解復健期間之進展，給予足夠隱私，逐步讓病人正視、參與造口照護，提供喜好的靜態娛樂方式，減輕焦慮，並尋求社會支援，予輔助與安置，透過個案管理系統，讓病人得以獲得持續且個別性的照護，出院後仍有所依靠。

This article describes an AIDS patient who was afraid of being discriminated against, and had no regular follow-up treatment, resulting in concurrent pneumocystis pneumonia and cytomegalovirus enteritis. The disease progressed and an artificial enterostomy was performed. Additionally, the patient's body mental image changed, resulting in anxiety, which prompted the author's motivation . From June 18 to July 13, 2021, direct care, observation, interactive methods to collect data, and using Gordon's eleven health function assessments, reveled, "activity intolerance", "body mental image dysfunction" and "anxiety" and other health problems. Intervention included, use of cross-team cooperative care during the nursing period, improving activity endurance through rehabilitation, providing patient with progress of rehabilitation using the exercise consciousness scale, giving enough privacy, and gradually allowing the patient to face up to and participate in stoma care. Through preferred static activities like listening to music and other entertainment methods to reduce anxiety, and assistance in seeking social support, assistance and placement, strengthen the social support system, and use the case management mechanism to allow patients to continue individualized care and still have something to rely on after discharge.

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