跨團隊共同照護失能老人靈性安適之經驗

The Experiences of Interprofessional Health Care in Spirituality for Disabled Old People

黃敏勤(Min-Chin Huang) ； 李榮真(June-Chen Lee)

《高雄護理雜誌》 36卷2期 (2019/08) Pp. 74-84

https://doi.org/10.6692/KJN.201908_36(2).0007

摘要

本文描述一位高齡女性患有多重慢性病且失能臥床，面臨憂鬱及心靈困擾之照護經驗。筆者藉由直接護理、查閱病歷、會談等方式收集資料。由身、心、靈性、社會各方面評估照護困境，歸納出三項問題：低效性呼吸型態、皮膚完整性受損及心靈困擾。經由醫師、護理師、復健師、營養師、出院準備服務個管師、社工師及宗教朋友跨團隊合作，給予全面性的協助。在恢復期指導家屬相關技巧，延續返家後的照護。過程中筆者察覺病人與女兒間深藏的憤怒。藉由肢體語言、會談傾聽建立良好護病關係，引導雙方表達內心情緒並紓解衝突，給予正向鼓勵肯定母女間情感存在意義和彌補其靈性層面的困擾，使照護過程更趨於完整。希望藉此經驗分享，使全人護理更完整精進。

關鍵字

失能 ； 老人 ； 靈性照護

並列摘要

This article describes the experience of nursing care for a bedridden elderly female with multiple chronic diseases confronted with depression and mental distress. The author collected the data through clinical care, medical chart, counseling, and observation, etc. After evaluation of physical, psychological, spiritual and social conditions, the author had the patient point out three of the main nursing issues: low efficacy of breath, skin integrity, and mental distress. Interprofessional teams included doctor, nurses, physical therapist, nutritionists, discharge planner, social worker and shared-religion friends, providing the patient and the family with psychological and illness care. The author prescribed medical care for both physical illness and mental distress through interprofessional health care, taught care skills to the family during the recovery phase, and assisted them with facing problems with home care. The author noticed the hidden anger and conflict between the patient and her daughter and intervened to achieve a good rapport with them, and through body language and counselling, guided them to express their feelings and resolve the conflict while giving positive feedback about the Daughter-Mother relationship for relief from mental distress. It is hoped that sharing this nursing experience will enable the completion of holistic health care in other cases.

並列關鍵字

disability ； elderly ； spirituality care

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