心臟移植病人的心理護(hù)理

Psychological Nursing Care for a Heart Transplant Patient

（情景一）

術(shù)后當(dāng)晚，經(jīng)過(guò)4 h麻醉蘇醒期，病人清醒。由于氣管插管接人工呼吸機(jī)輔助呼吸，無(wú)法說(shuō)話(huà)，只能用點(diǎn)頭等簡(jiǎn)單的動(dòng)作來(lái)表示她的意思。護(hù)士很清楚這時(shí)病人的心理情況，一直陪伴在身邊。

（Scene 1）

Four hours after the operation，the patient regained her consciousness from the anesthesia.She couldn’t talk because a tracheal tube was connected to the respirator.She could only express herself with some simple actions，such as nodding，etc.The nurse knew Mrs.Zhu’s psychological situation，so she stayed with her.

護(hù)士：（輕輕握住病人的手，語(yǔ)氣輕柔）朱麗，你聽(tīng)到我在喊你嗎？

病人：（輕輕點(diǎn)點(diǎn)頭，閉著眼睛）

護(hù)士：你醒了？感覺(jué)還好嗎？知道嗎，你已經(jīng)動(dòng)完手術(shù)了，很成功?，F(xiàn)在已經(jīng)在病房了。我是小李，記得我嗎？

病人：（點(diǎn)點(diǎn)頭）

護(hù)士：好的。朱麗，聽(tīng)我講，你的移植手術(shù)做得非常成功?，F(xiàn)在為了減輕你的負(fù)擔(dān)，要用呼吸機(jī)幫助你呼吸一段時(shí)間，所以插在嘴里的管子還不能拔掉，有點(diǎn)難受，忍一忍，好嗎？你只需好好的跟著機(jī)器呼吸就行了。我們給你用了鎮(zhèn)痛劑，暫時(shí)不會(huì)覺(jué)得疼痛，好好休息，我會(huì)一直在邊上陪你的。

（病人點(diǎn)點(diǎn)頭，握緊護(hù)士的手）

護(hù)士：別怕。我不離開(kāi)，你放心睡吧。

采用愛(ài)丁堡產(chǎn)后抑郁量表（EPDS）對(duì)護(hù)理后兩組產(chǎn)婦抑郁情況進(jìn)行評(píng)定，共10個(gè)條目，每個(gè)條目0～3分，總分30分，評(píng)分越高，表示產(chǎn)婦抑郁癥狀越嚴(yán)重[3-4]。采用本院自行設(shè)計(jì)擬定的護(hù)理滿(mǎn)意度問(wèn)卷對(duì)兩組護(hù)理后產(chǎn)婦的滿(mǎn)意度進(jìn)行統(tǒng)計(jì)，總分100分，分?jǐn)?shù)在90分及以上為非常滿(mǎn)意；分?jǐn)?shù)在70～89分為滿(mǎn)意；分?jǐn)?shù)不足70分為不滿(mǎn)意；總滿(mǎn)意=非常滿(mǎn)意+滿(mǎn)意。

（病人握著護(hù)士的手睡著了）

Interactions

Nurse：（holding the patient’s hand and talking to her softly）Mrs.Zhu，can you hear me？

Patient：（nodded with her eyes closed）

Nurse：You are awake.How do you feel now？The operation was a success and you are in the ward.I am nurse Li.Do you remember me？Patient：（nodded her head）

Nurse：Ok.Mrs.Zhu，congratulations.Your operation was very successful.The respirator will help you to breath for some time.Therefore the tube in your mouth can not be taken out.You may feel discomfort but you must bear it during this short period.What you should do is follow the rhythm of the respirator to breath.We have given you some analgesic so you won’t feel pain.Now take a good rest and I will stay with you.

（Patient nodded her head，grasped the nurse’s hand firmly）

Nurse：Don’t worry.I won’t leave.Relax and sleep now.

（The patient fell asleep while holding the nurse’s hand）

（李惠玲）

（情景二）

術(shù)后第二天，病人已拔除氣管插管，半臥位，鼻導(dǎo)管吸氧，已能進(jìn)少量流質(zhì)。今天又是小李值班。（Scene 2）

The tracheal tube was pulled out the second day after the operation.The patient was in a semi-reclining position on the bed，breathing with an oxygen nasal canula，and can take some fluid.It is nurse Li on duty again.

交流

護(hù)士：（語(yǔ)氣輕快）喲，朱麗，一天沒(méi)見(jiàn)，這么精神啦?？瓷先ゲ诲e(cuò)。（拉住病人的手）怎么樣，胃口好嗎？醫(yī)院的飲食吃得慣嗎？

病人：（勉強(qiáng)笑了一下）還可以。

Interactions

Nurse：（speaking quickly and happily）Hi，Mrs.Zhu，I haven’t seen you for only one day and you are looking so well（holding the patient’s hand）.How is your appetite？I am afraid you may not be used to the hospital foods.

Patient：（smiling reluctantly）The foods are fine.

（王玉宇）