粒腺體疾病併發妄想症病人之護理經驗

Nursing Care of a Patient with Mitochondrail Encephalomyopathy Complicated with Delusional Disorder

10.6530/YYN.2012.6(2).11

葉翠玉(Tsui-Yu Yeh)；陳采蕙(Tsi-Hwei Chen)；陳祐蓉(Yu-Jung Chen)；葉慧雯(Hui-Wen Yen)

粒腺體疾病 ； 妄想症 ； mitochondrail encephalomyepathy ； lactic acidosis ； stroke-like episodes disease ； delusional disorder

源遠護理

6卷2期（2012 / 11 / 01）

84 - 92

繁體中文

本文呈現照護一位罹患粒腺體疾病病人併發妄想症，而有思考障礙、睡眠紊亂及跌倒情形。護理期間為2008年6月30日－7月31日，經由評估進行資料收集，於照護過程以觀察、會談、相關檢查等方式收集主、客觀資料，並運用整體性護理評估及病人疾病之相關文獻，確立病人健康問題為思想過程改變、睡眠型態紊亂、潛在危險性跌倒。針對疾病予提供病人正確認知與照護，於護理過程中與病人及家屬建立良好的治療性人際關係，並教導病人學習自我照顧因疾病而引發之生理及心理上之症狀而及時就醫，鼓勵家屬與病人面對疾病，日常生活照護及支持照護。病人於住院期間學會用溝通方式與家人相處互動，言談呈現病識感，在醫療團隊的照護下，病人的認知功能及睡眠障礙於照護三週後有明顯改善並減少發生跌倒。於病人出院後電話及門診追蹤治療，病人可在家人協助下，呈現較佳的情緒管理與疾病照顧。

This article examines a patient disgnosed with mitochondrail encephalomyopathy, lactic acidosis, and stroke-like episodes that lead to delusional disorder. Subjective and objective information was gathered during a month long care in 2008 through observation, direct interview and physical examinations. Nursing evaluations and literature search identified the patient's major health problems as thought and sleep disturbance and fall with risk of injury. Good rapport and therapeutic relationships facilitated patient teaching on self-care of physical and mental symptoms, when to seek medical help, and appropriate communication skills with family members. Family members were encouraged to provide support of the patient' daily care activities. The patient was able to gain insight during hospitalization with marked improvement on cognitive functions, sleep disturbance and reduced risk for fall. Post discharge telephone and medical office follow-up indicated that the patient continued to improve in emotional control and self-care under the supportive care of family members.