運用不確定感理論於一位裝置永久性心臟節律器病人的護理經驗

A Nursing Care Experience for a Patient with Implanted Permanent Pacemaker by Applying Uncertainty Theory

張兆香(Chao-Hsiang Chang) ； 何秀玉(Hsiu-Yu Ho) ； 郭素青(Su-Ching Kuo) ； 陳佩英(Pei-Ying Chen)

《新臺北護理期刊》 17卷1期 (2015/03) Pp. 109-117

https://doi.org/10.6540/NTJN.2015.1.011

摘要

本文描述一位裝置永久性心臟節律器病人手術前後不確定感之照護經驗。護理期間2011年8月16～23日，筆者運用Mishel疾病不確定感理論為架構，經由訪談、觀察、身體評估和查閱病歷等方式收集資料，評估病人有不確定感之護理問題，不確定感的原因包括不了解醫療處置過程、傷口照護、術後日常活動限制及心臟節律器相關資訊。筆者藉由衛教單張、圖片和影片向病人詳細解釋醫療處置過程、心臟節律器相關資訊和日常活動限制等，並示教與回覆示教病人和家屬有關傷口照顧技巧，同時給予病人心理支持，逐一澄清其疑慮和降低其不確定感，並以疾病不確定感量表評值病人的疾病不確定感已被減輕。希望藉此照護經驗提供護理人員照護此類病人的參考。

關鍵字

不確定感 ； 心臟節律器 ； 疾病不確定感量表

並列摘要

This paper presented the nursing care experience for a patient with implanted permanent pacemaker emerging the uncertainty before and after the operation, between 16 and 23 August 2011. Mishel's Uncertainty Theory was used to assess and analyze the data collected by observation, interview, physical assessment, and chart review. The identified nursing problem was uncertainty, which the included reasons were lack of understanding medical treatment process, taking care of skills for wound and daily activity restriction after operation, and lack of information related to pacemaker. The medical treatment process, related pacemaker information and daily activities were explained in detail by nursing education in handout, picture and DVD, and the care skills for wound were demonstrated and repeated what were demonstrated earlier to the client and relatives. Also, the psychological support was offered to clarify the client's questions and to lower his uncertainty (evaluated by Illness Uncertainty Scale). I would look forward to sharing this nursing care experience with other nurses who are going to take care of similar patients.

並列關鍵字

Uncertainty ； Pacemaker ； Illness uncertainty scale

參考文獻

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