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[临床病例:基层医疗中的复杂性哀伤。护理计划]

[Clinical case: Complicated grief in primary care. Care plan].

作者信息

Ruymán Brito-Brito Pedro, Rodríguez-Ramos Mercedes, Pérez-García-Talavera Carlos

机构信息

Servicio Canario de Salud, Gerencia de Atención Primaria, Area de Salud de Tenerife, España.

出版信息

Enferm Clin. 2009 Nov-Dec;19(6):345-8. doi: 10.1016/j.enfcli.2009.07.011. Epub 2009 Oct 24.

Abstract

This is the case of a 61-year-old patient woman that visits her nurse in Primary Health Care to get the control of blood pressure and glycemia. In the last two years has suffered the loss of her husband and of two brothers beside having lived through other vital stressful events that have taken her to a situation of complicated grief. The care plan is realized using the M. Gordon assessment system and standardized languages NANDA, NOC and NIC. The principal aims were the improvement of the depression level and the improvement in the affliction resolution. As suggested interventions were proposed to facilitate the grief and the derivation to a mental health unit. A follow-up of the patient was realized in nursing consultation at Primary health care to weekly intervals, in the beginning, and monthly, later. The evaluation of the care plan reflects an improvement in the criteria of Prigerson's complicated grief; an increase of the recreative activities; the retreat of the mourning that still she was guarding; as well as an improvement in the control of the blood pressure numbers. The attention of nurses before a case of complicated grief turns out to be complex. Nevertheless the suitable accomplishment of certain interventions orientated to facilitating the grief, with a follow-up in consultation, shows the efficiency. The difficulty in the boarding of the psychosocial problems meets increased at the moment of are necessary the nursing diagnostics adapted for every individual case. The work in group between nurses could improves the consensus.

摘要

这是一位61岁女性患者的案例,她前往初级卫生保健机构找护士控制血压和血糖。在过去两年里,她失去了丈夫和两个兄弟,还经历了其他重大生活压力事件,这使她陷入了复杂悲伤的境地。护理计划采用M. 戈登评估系统以及标准化语言NANDA、NOC和NIC来制定。主要目标是改善抑郁程度以及提高痛苦解决能力。建议采取干预措施以促进悲伤情绪的缓解,并将患者转介至心理健康科。起初,在初级卫生保健机构的护理咨询中对患者进行每周一次的随访,之后改为每月一次。护理计划评估显示,普里格森复杂悲伤标准有所改善;娱乐活动增加;她仍在坚守的哀悼情绪减退;血压数值控制也有所改善。面对复杂悲伤案例时,护士的护理工作颇具挑战性。然而,通过实施某些旨在促进悲伤缓解的适当干预措施,并进行咨询随访,显示出了成效。在需要针对每个具体案例进行护理诊断时,处理心理社会问题的难度会增加。护士之间的团队合作可以提高共识。

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