照顧一位Guillain-Barré syndrome病人護理經驗

Nursing Experience of Caring for a Patient with Guillain- Barré Syndrome

10.6740/NTUHJN.202401_20(1).0005

劉芷阡(Chih-Chien Liu)；陳惠美(Hui-Mei Chen)

焦慮 ； 身體活動功能障礙 ； 疼痛 ； Anxiety ； Guillain-Barré syndrome ； pain

臺大護理雜誌

20卷1期（2024 / 01 / 01）

40 - 51

繁體中文;英文

本文敘述一位29歲男性初診斷Guillain-Barré syndrome，因病情導致肢體無力、麻刺感造成身體活動功能障礙以及治療與預後的未知產生焦慮情緒之護理經驗。本篇護理期間自2021/9/6-2021/9/25，運用Gordon十一項功能性健康型態表為評估工具，透過直接照護、實際觀察、會談、查閱病歷等方式收集主客觀資料，確立個案主要三個健康問題為身體活動功能障礙、急性疼痛、焦慮。照護期間運用主動關懷，引導個案表達內心感受，同理並接受個案的負向情緒，透過衛教指導加強個案對疾病的認知，經跨團隊合作並協同個案與家屬共同擬定復健日程表，使個案對於疾病有參與感及自主權，並藉由病友的分享，增強個案對治療及復健的信心，使其能以正向態度面對疾病且持續進行復健，由於病情急遽造成此類病人身體活動功能障礙，建議可將有積極復健潛能的病人納入健保規劃的急性後期整合照護計畫對象。於此個案出院後，我們以電話追蹤其復健情形，並對其返家後所面臨之問題給予建議；依此個案之照護經驗，此類病人能透過密集復健加快神經功能恢復，提升自我照顧能力，幫助提升生活品質並且早期回歸社區。

This article describes the nursing experience of a 29-year-old man diagnosed with Guillain-Barré syndrome who experienced limb weakness and numbness, resulting in dysfunction of physical activities and fear and anxiety of unknown treatment and its prognosis. We collected data through direct care, observation, interviews, and review of medical records, assessed using Gordon's 11 functional health patterns from September 6 to 25, 2021, and identified primary health concerns for the patient, including impaired physical mobility, acute pain, and anxiety. During the caregiving period, we guided the patient to express his inner feelings with a proactive companion, empathize with and accept negative emotions, and enhance his understanding of the illness through health education. We applied transdisciplinary teamwork and shared decision-making with the patient and his family in a rehabilitation program and provided mental support to empower participation and autonomy in managing the illness. In addition, we enhanced his confidence and positive attitude by sharing the experiences of other patients, which enabled him to engage in continuous rehabilitation. Owing to the rapid development of physical disabilities, we suggested enrolling the patient in a post-acute integrated care program under the health insurance plan. After discharge, we monitored his rehabilitation condition by telephone and provided suggestions regarding the problems he encountered at home. In our experience, intensive rehabilitation could increase the recovery of neurological function, improve self-care skills, enhance the quality of life, and help patients return to society early.