照顧一位庫賈氏病個案居家照護經驗

A Home Health Nursing Experience of Caring a Patient with Creutzfeldt-Jakob Disease

本文描述照護一位庫賈氏病個案的居家照護經驗，過程中個案除了面臨身、心巨大壓力外，又因第四類傳染病所帶來輿論壓力承受雙重打擊的照護經驗。照護期間自2015年1月24日至6月26日，以Gordon十一項健康功能評估模式，居家訪視6次、電訪10次，採觀察、會談、身體評估等方式收集主客觀資料，確立健康問題有便秘/腸蠕動慢、水分及纖維攝取不足；身體活動功能障礙/與庫賈氏症造成神經肌肉障礙有關；照顧者角色緊張/照顧者對傳染疾病照護工作感到壓力及缺乏照護經驗等健康問題。藉由適時教導被動關節運動、增加纖維及水分攝取、腹部按摩等技巧緩解便秘及身體活動功能障礙導致的關節僵硬問題，透過主動關懷、傾聽、與居家訪視、社會資源提供等方式讓照顧者可正向面對照顧壓力，進而調適緊張壓力，維持良好照護品質與生活型態。建議照顧此類個案中，除了提供個案完善居家照護外，亦應提供照顧者自我防護技巧，並引導照顧者適時紓解照護壓力，以減輕其照護負荷。 This paper presents the experience of home health nursing for a patient with Creutzfeldt-Jakob disease. The patient did not only need to face his stress, but also encounter the challenge of being diagnosed with the 4th category of infectious diseases. The nursing period was from January 24th to June 26th, 2015, and assessment with Gordon’s 11 function health patterns was performed. There were 6 times of home visiting and 10 times of telephone interviews. All the subjective and objective data were collected with observation, interviewing, and physical examination. The health problems of this case were: constipation/bowel movements slow, water and fiber intake insufficiency, physical dysfunction/ neuromuscular disorders caused by Creutzfeldt-Jakob disease, and caregivers are facing their family having the infectious diseases. And role tension of caregivers/caregivers concerned with infectious diseases. The nursing care provided included teaching passive joint exercise, increasing fiber and water intake, and messaging abdomen for the patient. Actively caring for the caregivers and the patient, listening, increasing frequency of home visits, and providing social resources were used positively faces the stress of the caregivers to relieve their burdens, and maintain quality of care and lifestyle. From this experience, we suggest providing well home health care for patients with Creutzfeldt-Jakob diseases, but also have to pay attention on self-care skills of the caregivers. As a result, those caregivers can relieve from their stress and burdens.

This paper presents the experience of home health nursing for a patient with Creutzfeldt-Jakob disease. The patient did not only need to face his stress, but also encounter the challenge of being diagnosed with the 4th category of infectious diseases. The nursing period was from January 24th to June 26th, 2015, and assessment with Gordon’s 11 function health patterns was performed. There were 6 times of home visiting and 10 times of telephone interviews. All the subjective and objective data were collected with observation, interviewing, and physical examination. The health problems of this case were: constipation/bowel movements slow, water and fiber intake insufficiency, physical dysfunction/ neuromuscular disorders caused by Creutzfeldt-Jakob disease, and caregivers are facing their family having the infectious diseases. And role tension of caregivers/caregivers concerned with infectious diseases. The nursing care provided included teaching passive joint exercise, increasing fiber and water intake, and messaging abdomen for the patient. Actively caring for the caregivers and the patient, listening, increasing frequency of home visits, and providing social resources were used positively faces the stress of the caregivers to relieve their burdens, and maintain quality of care and lifestyle. From this experience, we suggest providing well home health care for patients with Creutzfeldt-Jakob diseases, but also have to pay attention on self-care skills of the caregivers. As a result, those caregivers can relieve from their stress and burdens.