一位喪偶女性諮詢健康檢查後治療抉擇之護理經驗

本文描述一位有慢性病及癌症家族史之喪偶女性，經健康檢查後意外發現顱內動脈瘤，因個案處於喪偶後哀傷期且無病識感，影響其服藥遵從性及手術意願之護理經驗。護理期間自2017年8月3日至9月22日，依個別性規劃健康檢查項目後，藉由陪伴、傾聽與同理心建立良好護病關係，以觀察、會談、病歷查閱、電訪及Gordon十一項功能性健康型態評估等方式收集資料及評估，確立個案主要健康問題有不遵從、睡眠型態紊亂、哀傷、焦慮。筆者運用護理獨特功能，提供專業健康照護知識，首先引導個案重視高血壓疾病，增加服藥的遵從性，同時藉由哀傷輔導協助走出喪偶的心理創傷與衝擊，順利恢復睡眠品質，接著運用溝通技巧共同探討壓力源、鼓勵說出焦慮原因、提供手術前、後正確醫療資訊，透過介紹成功案例，給予關懷及正向回饋，進而改善焦慮並接受手術治療。因筆者為個管師角色，個案住院中未能直接照顧，藉由住院時多次探訪，並於出院後利用電訪持續追蹤術後及居家生活情形，以達連續性整體照護。另建議手術前麻醉訪視針對重大手術者能到加護中心實地探訪，由專業人員介紹環境及術後相關管路等，緩解個案手術前焦慮。期望藉此護理經驗分享，作為日後照護類似個案之參考。

關鍵字

喪偶女性；健康檢查；護理經驗

並列摘要

This article describes a widowed woman with family history of chronic diseases and cancer. She was diagnosed with an intracranial aneurysm by accident after conducting health examination. The nursing experience took place because of her sorrow after becoming a widow and she had no sense of the illness and further affected her medication compliance and willingness to corporate. The caring period was from August 3 to September 22 in 2017 after customized planning a health checkup project. By means of companionship, listening and empathy to establish a good nursing relationship, collecting information and assessing by observation, interviews, medical records review, phone interview and applied Gordon's eleven functional health assessments. Establishments of the patient encountered health issues such as non-compliance, sleep disturbances, grief, and anxiety. The author applies the unique features of nursing and provides professional health care knowledge. Firstly, the case was guided to pay attention to her hypertension and improving her compliance of medication. At the same time, assistance of getting over the psychological trauma of being a widow and gradually recover her sleep quality. Subsequently applying communication skills to discuss the cause of stress, encouraging the patient to express anxiety, and provide accurate medical information before and after surgery. Hence provide care and positive feedback by introducing successful cases, thereby improving anxiety and undergoing surgery. The author was a supervisor and was not able to take care of the patient directly during hospitalization. Through multiple visits during hospitalization, and after the discharge, the follow-up and home life are continuously tracked by telephone interviews to achieve uninterrupted overall care. Site visit is also recommended before anesthesia for major surgery patient in care centers. Professional introduction of the environment and postoperative associated circuits can relieve individual anxiety before surgery. Hopefully this experience will provide caring references for similar cases in the future.