肺移植病人的心理護(hù)理

Psychological Nursing Care for a Patient with Lung Transplantation

交流

護(hù)士：XX，現(xiàn)在我們使用面罩來(lái)幫助你呼吸，有些不舒服，你可能覺(jué)得鼻子、嘴巴和外界空氣隔開(kāi)了，放心，呼吸機(jī)能夠提供你足夠的氧氣，絕對(duì)保障你的安全。

病人：（點(diǎn)頭示意）

護(hù)士：從插管到使用面罩是一個(gè)很大的進(jìn)步，情況一天比一天好，一定要有信心?，F(xiàn)在你要配合好呼吸機(jī)，吸氣時(shí)閉上嘴巴，氣就不會(huì)打進(jìn)胃內(nèi)，試試看！

護(hù)士：很好！面罩很緊？這是為了不泄漏，保證呼吸機(jī)給你最有效的呼吸支持，當(dāng)然我們會(huì)給你間斷松開(kāi)的。

病人：（試做）病人：（點(diǎn)頭）

護(hù)士：有什么需要做手勢(shì)告訴我們，好嗎？右手邊有個(gè)鈴鐺，摸摸看！感覺(jué)不舒服敲這個(gè)鈴鐺，好嗎？

Interactions

Nurse：Mr.XX，the mask is used to help you breathe.You may experience some discomfort.You may feel that your nose and mouth are blocked from the outside air.But don＇t worry.The respirator will provide enough oxygen to you and it is absolutely safe.

Patient：（nodding）

Nurse：It is a great progress from the use of trachea incubation to the use of mask.Your condition has become better and better every day.Now you should work with the respirator and close your mouth during inhalation to avoid air from getting into your abdomen.Try it，OK？

Patient：（trying）

Nurse：Very good.The mask is tight，isn＇t it？This is because we want to make sure that the respirator will supply the most effective air flow to you.Certainly，we＇ll loose it intermittently.

Patient：（nodding）

Nurse：Please make gestures to show your needs，OK？There＇s a bell next to your right hand.Feel it！You can ring it when you feel uncomfortable.

結(jié)果

病人對(duì)無(wú)創(chuàng)呼吸面罩存在恐懼感。護(hù)理人員首先應(yīng)確認(rèn)和重視患者的恐懼心理反應(yīng)，解釋面罩的安全性質(zhì)，消除其顧慮。然后需肯定面罩的使用是正性過(guò)程，使病人愿意接受，并指導(dǎo)病人正確的配合，最大程度地減少不適。

Result

The patient is frightened by the non-invasive respirator.First，the nurses should accept her fear and tell her the safety features of the respirator to alleviate her anxiety.Then the nurses should ensure the patient that the use of the mask is a positive process which will lead the patient to accept the equipment.Guiding the patient to learn the right usage of the machine will also minimize the patient＇s uneasiness.

點(diǎn)評(píng)

器官移植是新興醫(yī)學(xué)，因此進(jìn)行器官移植的病人對(duì)自身安全感的焦慮會(huì)更甚于其他病人。他們迫切需要得到來(lái)自于醫(yī)護(hù)人員、社會(huì)家庭的各種信息和情感支持，以證實(shí)生命不再受到威脅。在上述三例交流會(huì)話中，可以體會(huì)到護(hù)理人員對(duì)他們的心理問(wèn)題進(jìn)行了合理的疏導(dǎo)。護(hù)理人員把檢查、治療的必要性，副作用都作了詳盡的說(shuō)明，比較了利弊得失，幫助病人權(quán)衡輕重，給予適當(dāng)?shù)陌踩凳竞捅ＷC，從而減輕了他們的焦慮、懼怕，并主動(dòng)配合治療和護(hù)理工作。

Comments

Organ transplantation is a new medical technology.The patients who underwent this procedure usually exhibit more anxiety and concerns about their safety much more than other patients.They tend to need more information and emotional supports from the medical personnel as well as the society and the family members，to ensure themselves out of danger.In the above listed three dialogues，the nurses made detailed explanation about the importance of the examination，the treatment，the side-effects，and so on.The nurse also compared the positive and the negative effects，gave the patient appropriate safe suggestions and reassurance which alleviated the patient＇s anxiety and fear，and obtained his cooperation with the treatments and nursing care.

（蔣芳琴）