協助一位短腸症病患接受居家靜脈營養之護理經驗

This case report describes a homecare nurse's experience in caring a client with short bowel syndrome and receiving total parenteral nutrition (TPN) at home. Face-to-face interviews and observations were conducted using Gordon's 11 Functional Health Patterns for data collection. Three nursing problems emerged which were related to: (1) insufficient nutrition; (2) health-seeking behaviors related to receiving home TPN, and (3) ineffective coping related to illness. The author established and maintained a trust relationship with the client and her family members, and provided them information on TPN at home. In addition, empathy and active listening were used to support and encourage the client to express her concerns and feelings toward her illness and reduce her anxiety. Several strategies were used to motivate the client to better self-care and maintain a good quality life.
本個案報告主要探討一位短腸症病患，接受居家靜脈營養之護理經驗。筆者於97年3月28日至8月20日護理期間，藉由一對一會談、觀察等技巧以Gordon十一項功能健康型態功能評估，並與個案及家屬建立良好治療性人際關係及信任感，收集資料進行分析後確立個案護理問題有(1)營養狀況少於身體需要／與小腸大量切除導致短腸症候群有關、(2)健康尋求行為／與居家靜脈營養照護有關、(3)個人因應能力失調／與疾病有關。護理過程中運用專業知識和技能，教導個案居家靜脈營養相關知識和技術，且採持續性的關懷、傾聽並以同理心鼓勵個案說出內心感受，協助降低心中不安與焦慮，使個案激發起自我學習照顧的動機，提升自我照顧及調適能力，以維持最佳生活品質。