運用Watson關懷理論於男同性戀者降低反覆自殺行為之護理經驗

Nursing Experience Using Watson's Caring Theory to Mitigate Suicidal Behaviors in a Homosexual Male

王雅慧(Ya-Hui WANG) ； 李名蟬(Ming-Chan LEE)

《護理雜誌》 66卷2期 (2019/04) Pp. 107-114

https://doi.org/10.6224/JN.201904_66(2).14

摘要

本文描述一位男同性戀者，反覆出現自殺自傷行為之護理經驗。護理期間為2016年10月7日至2016年11月7日，藉由整體性護理評估、觀察、會談收集資料，確立健康問題有：無效性因應能力、家庭因應能力失調。個案因感情受挫及家人尚無法接受其性向，無法調適情緒壓力，反覆以自殺自傷行為因應壓力情境，筆者運用Watson關懷理論十項照護因素於護理措施之中，發揮關懷本質尊重與接納，建立治療性人際關係，並以自殺防治概念之保護因子做為因應策略，辨識可能引發個人自殺想法的事件與反應，協助自我覺察、增加控制力，降低自殺自傷想法與行為。個案和父母衝突不斷，原本和諧的家庭關係受到衝擊，故以家庭為中心之照護，促進家庭復原力，讓雙方共同發展更多學習與成長空間，重建和諧健康的家庭，期望藉此照護經驗以供臨床參考。

關鍵字

Watson關懷理論 ； 反覆自殺自傷 ； 男同性戀

並列摘要

This report describes our experience providing nursing care between 7th October and 7th November 2016 to a homosexual male who repeatedly engaged in stress-related suicide attempts and self-harm. Information was collected using comprehensive nursing assessment, observation, and interviews and the health problems of ineffective coping and disabled family coping were identified. Because of affection-related distress and the lack of recognition of his gender orientation by his family, the client engaged repeatedly in self-harm and attempted suicide on several occasions in order to cope with the self-perceived unbearable stress and stressful situations. The authors provided nursing care based on Watson's theory of human caring. We fulfilled the nature of caring, prompted respect and acceptance, and established a therapeutic, interpersonal relationship. We also adopted the concept of suicide intervention, and used the protective factors as the main coping strategies. These approaches allowed the client to acknowledge the events and reactions that may trigger his suicidal ideas, to develop better self-reflection and impulse control, and to mitigate the ideas and behaviors related to suicide and self-harm. Because constant conflicts between the client and his parents hampered a harmonious family relationship, we adopted family-centered care in order to enhance family resilience, which created room for mutual learning and development and reconstructed a healthy family relationship. Our successful results with this case encouraged our writing this paper in order to share this nursing experience with caregivers facing similar client situations and needs.

並列關鍵字

Jean Watson's theory of human caring ； repeated suicide and deliberate self-harm ； homosexual male

參考文獻

鍾佳樺、羅子寧、溫筱涵、汪素敏、徐南麗（2016）．同性戀認知面面觀．健康與建築雜誌，3（1），38–44。[Chung, C. H., Lo, T. N., Wen, H. H., Wang, S. M., & Hsu, N. L. (2016). Overview of cognition for homosexuality. Journal of Health and Architecture, 3(1), 38–44.] https://doi.org/10.6299/JHA.2016.3.1.R5.38

翁雪芳、陳敏麗（2013）．運用冥想式放鬆技巧於一位乳癌手術後病患之護理經驗．新臺北護理期刊，15（1），79–88。[Weng, H. F., & Chen, M. L. (2013). The experience in using meditation-Relaxation techniques in post-operative care for breast cancer patient. New Taipei Journal of Nursing, 15(1), 79–88.] https://doi.org/10.6540/NTJN.2013.1.008

衛漢庭、陳牧宏、徐志雲（2014）．同志友善醫院：健康照護平權指標．台灣醫學，18（3），333–337。[Wei, H. T., Chen, M. H., & Hsu, C. Y. (2014). LGBT friendly healthcare services: Healthcare equality index. Formosan Journal of Medicine, 18(3), 333–337.] https://doi.org/10.6320/FJM.2014.18(3).9

陳宜明、李明濱、林帛賢、廖士程（2013）．蓄意自傷行為之評估與處理．台灣醫學，17（3），309–316。[Chen, I. M., Lee, M. B., Lin, P. H., & Liao, S. C. (2012). The evaluation and management of deliberate self-harm behavior. Formosan Journal of Medicine, 17(3), 309–316.] https://doi.org/10.6320/FJM.2013.17(3).12

衛漢庭、陳牧宏、顧文瑋（2015）．建構多元性別友善的醫療服務．護理雜誌，62（1），22–28。[Wei, H. T., Chen, M. H., & Ku, W. W. (2015). Fostering LGBT-friendly healthcare services. The Journal of Nursing, 62(1), 22–28.] https://doi.org/10.6224/JN.62.1.22