協助一位肝硬化遊民病患重建生活控制感的護理經驗

A Nursing Experience about Assisting a Homeless Cirrhosis Patient in Rebuilding a Sense of Control of His Life

紀麗雪(Li-Hsueh Chi)；孫美華(Mei-Hua Sun)

遊民 ； 肝硬化 ； 無力感 ； Homeless ； Liver cirrhosis ； Powerlessness

亞東學報

34期（2014 / 12 / 01）

117 - 125

繁體中文

本文描述一位對於生理健康狀況及未來生活控制喪失信心的肝硬化遊民個案，引導其重建生活控制感及接受安置計劃的護理過程。筆者於2010年9月7日至9月27日照護期間，運用觀察、會談及Gordon十一項功能性健康型態進行評估，確立個案呈現低效性呼吸型態、營養不均衡：少於身體需要、無力感等健康問題。藉由提供及指導個案營養照護計劃及每日飲水量替換計算方式，達到體液控制進而緩解呼吸喘之症狀；結合社會資源，安排機構安置、給予固定食物來源來滿足個案基本生理及居住需求；提供疾病相關護理指導來提升對於健康的自我控制感，另與個案共同討論出院後可能面臨的問題，藉由增進日常照顧能力及重建未來生活控制感來降低無力程度，使能正向面對出院後生活。此照護經驗能讓個案回歸日常生活及重返職場，對於相關個案的臨床照護具有重要性參考價值。

The purpose of this article was to describe a homeless patient who lost confidence in his physical health condition and future life prospects. Subsequently, he was accepted a resettlements plan due to successful nursing care and guidance. During the period of nursing care, from September 7 to 27, 2010, the author used observation, interviews, and Gordon’s functional health assessment tool to conduct evaluations in order to identify patient's health problems including ineffective breathing pattern, imbalanced nutrition: less than body requirements, powerlessness. The author offered diet principles of liver cirrhosis and daily water replacement computations, then his fluid levels were controlled, thereby relieving the symptoms of dyspnea. Combining the social resources that give regularly food supplies for meet his basic need. Providing nursing instructions about disease were helped the patient increased level of self-control ability. Moreover, problems related to discharge from hospital were also discussed with the patient, in order to help the patient build a sense of control over his life and reduce his sense of powerlessness. That would help the patient to face life with a positive attitude upon leaving hospital. We hope this nursing experience can prove the nursing staff a reference when taking care of such patients.

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