運用Watson關懷理論於一位乙狀結腸癌手術病人之護理經驗

Nursing Experience from Caring a Patient with Sigmoid Colon Cancer Surgery by Applying Watson Caring Theory

王宜鈴(Yi-Ling Wang) ； 林心怡(Hsin-Yi Lin)

《領導護理》 21卷1期 (2020/03) Pp. 48-62

https://doi.org/10.29494/LN.202003_21(1).0005

摘要

隨著飲食生活習慣的逐漸西化，近年來大腸直腸癌的病例在台灣及世界其他國家有日趨增多之趨勢。本文旨在探討照顧一位乙狀結腸癌手術病人之護理經驗，護理期間自2016年1月11日至1日19日。藉由觀察、會談、身體評估及病歷查閱等方式，進行整體性評估後個案有以下的護理問題：（1）情境性低自尊／與疾病的自我負向情緒引發對案兒感到愧疚感有關、（2）疼痛／與手術傷口及引流管留置有關、（3）潛在危險性感染／與侵入性治療有關，筆者運用Watson十項關懷照護理論為基礎，提供人性化護理、同理、尊重，建立良好護病關係，了解個案問題及需求並主動聯繫各醫療團隊成員，為個案舉辦病情說明會，藉由I PAD及3D人體模型，一一加以說明，鼓勵說出內心疑問及感受，採共同討論照護模式，以達到雙向溝通，另筆者及案夫傾聽、陪伴，鼓勵個案表達正負向感受，時時給予正向鼓勵，經過努力後使個案重拾自信心及希望，能正向思考及自我肯定，期盼藉由此護理經驗提供日後照護相似個案之護理參考及分享。

關鍵字

乙狀結腸癌 ； 情境性低自尊 ； Watson關懷理論

並列摘要

In recent years, along the pace with the gradual westernization of eating habits, the cases number of colorectal cancer have a tendency to increase in Taiwan and many other countries. This article explores the care experience from taking care of a sigmoid colon cancer patient. Nursing period is from January 11st to 19^(th) of 2016. Through observation, interviews, physical assessment and medical records review, the following issues were identified: the condition of low self-esteem, pain, and potential risk of infection. The author applies Watson's Ten Caring Theory as foundation, in order to provide human care, to understand the patient's individual issues and demands, and hence contact the relevant medical team members proactively. Furthermore organize a briefing session for this particular case, with the aids of iPad and 3D human models, the patient's conditions were explained one by one and she was encouraged to express all inner queries and feelings. The author adopts a common discussion of care models to achieve two-way communication. Additionally, the author and the patient's partner both are accompanying the patient closely to also listen, and encourage the patient to express both positive and negative feelings, so the patient regains self-confidence and hope. Hopefully this experience will provide caring references for similar cases in the future.

並列關鍵字

sigmoid colon cancer ； low self-esteem ； Watson caring theory

參考文獻

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