心臟移植病人的心理護理

心臟移植病人的心理護理

Psychological Nursing Care for a Heart Transplant Patient

（情景一）

術后當晚，經過4 h麻醉蘇醒期，病人清醒。由于氣管插管接人工呼吸機輔助呼吸，無法說話，只能用點頭等簡單的動作來表示她的意思。護士很清楚這時病人的心理情況，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.

護士：（輕輕握住病人的手，語氣輕柔）朱麗，你聽到我在喊你嗎？

病人：（輕輕點點頭，閉著眼睛）

護士：你醒了？感覺還好嗎？知道嗎，你已經動完手術了，很成功。現在已經在病房了。我是小李，記得我嗎？

病人：（點點頭）

護士：好的。朱麗，聽我講，你的移植手術做得非常成功。現在為了減輕你的負擔，要用呼吸機幫助你呼吸一段時間，所以插在嘴里的管子還不能拔掉，有點難受，忍一忍，好嗎？你只需好好的跟著機器呼吸就行了。我們給你用了鎮痛劑，暫時不會覺得疼痛，好好休息，我會一直在邊上陪你的。

（病人點點頭，握緊護士的手）

護士：別怕。我不離開，你放心睡吧。

采用愛丁堡產后抑郁量表（EPDS）對護理后兩組產婦抑郁情況進行評定，共10個條目，每個條目0～3分，總分30分，評分越高，表示產婦抑郁癥狀越嚴重[3-4]。采用本院自行設計擬定的護理滿意度問卷對兩組護理后產婦的滿意度進行統計，總分100分，分數在90分及以上為非常滿意；分數在70～89分為滿意；分數不足70分為不滿意；總滿意=非常滿意+滿意。

（病人握著護士的手睡著了）

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）

術后第二天，病人已拔除氣管插管，半臥位，鼻導管吸氧，已能進少量流質。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

護士：（語氣輕快）喲，朱麗，一天沒見，這么精神啦。看上去不錯。（拉住病人的手）怎么樣，胃口好嗎？醫院的飲食吃得慣嗎？

病人：（勉強笑了一下）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）