運用Swanson關懷理論於一位血管炎導致無力感老人之護理經驗

Applying Swanson's Theory of Caring to Manage Powerlessness in an Older Patient With Vasculitis

陳寅慈(Yin-Tzu CHEN) ； 林欣絨(Sin-Rong LIN) ； 高綺吟(Chi-Yin KAO)

《護理雜誌》 66卷3期 (2019/06) Pp. 112-119

https://doi.org/10.6224/JN.201906_66(3).14

摘要

本文為描述運用Swanson關懷理論於一位因血管炎疾病無法行走及延後出院，而產生無力感老人之護理經驗。照護期間為2018年4月26日至2018年5月5日，經生理、心理、社會及靈性四大層面進行評估，確立個案存有身體活動功能障礙及現存性感染等生理問題，且延伸出無力感之護理問題。透過Swanson關懷理論中所提之了解、在旁陪伴、為他做某些事、使他能夠與維持信念的五大關懷核心，引導個案參與自我的治療計畫，增強其復健動機；並協助家屬提升照護的能力及信心，為返家做準備；另結合宗教的關懷，鼓勵個案情緒抒發，學習正向紓解方式，達到心靈的安適。同時從生理、心理及靈性層面著手，協助個案重新找回自己的價值，提升對於未來的正向信念。藉由此照護經驗，期盼給予護理人員在照護因疾病而導致無力感的老年病人參考及運用。

關鍵字

Swanson關懷理論 ； 無力感 ； 血管炎

並列摘要

This case report describes a nursing care experience that applied Swanson's Caring Theory to a powerless elderly patient who was suffering from vasculitis problems that had made her incapable of walking and had delayed her discharge from the hospital. The associated health problems, including impaired physical mobility, infection, and powerlessness, were affirmed after an integrated physical, psychological, social, and spiritual assessment was conducted during the nursing care period, which lasted between April 26th and May 5th, 2018. The five categories (knowing, being with, doing for, enabling, maintaining belief) of Swanson's Caring Theory were applied. The patient was encouraged to participate in the treatment plan and motivated to participate in rehabilitation. In addition, the caring capacity and care confidence of family members was enhanced in order to support the patient’s further care after discharge. Furthermore, religious support was involved, which allowed the patient to communicate her emotions, reduce her stress, and achieve spiritual comfort. By providing care in the realms of physiology, psychology, and spirit, the author helped the patient regain her self-worth and enhance her positive beliefs in the future. This case report is hoped to provide medical staffs with a reference for facilitating the recovery of elderly patients experiencing disease-related powerlessness.

並列關鍵字

Swanson's theory of caring ； powerlessness ； vasculitis

參考文獻

王文佩、許心恬（2014）．運用Swanson關懷理論照護一位肺癌末期患者靈性困擾之護理經驗．護理雜誌，61（4），97–102。[Wang, W. P., & Hsu, H. T. (2014). Applying Swanson's caring theory to manage spiritual distress in a patient with terminal lung cancer. The Journal of Nursing, 61(4), 97–102.] https://doi.org/10.6224/JN.61.4.97

周昌德、黃榆盈、黃慧雯（2014）．類風濕性關節炎治療之策略及照護．榮總護理，31（2），129–136。[Chou, C. T., Huang, Y. I., & Huang, H. W. (2014). Strategy and care in the treatment of rheumatoid arthritis. VGH Nursing, 31(2), 129–136.] https://doi.org/10.6142/VGHN.31.2.129

胡嘉桂、林佩昭（2018）．運用Swanson關懷理論照護一位脊髓腫瘤復發癌症病人無望感之護理經驗．領導護理，13（9），34–49。[Hu, C. K., & Lin, P. C. (2018). Nursing experience in utilizing Swason's caring theory for hopelessness in a cancer patient with recurrent intramedullary tumors. Leadership Nursing, 13(9), 34–49.] https://doi.org/10.29494/LN.201809_19(3).0004

范曉雯、張方、許育瑞、吳毓慧（2015）．一位抗嗜中性球細胞質抗體血管炎合併腎臟侵犯病人接受血液透析及血漿置換術之照護經驗．源遠護理，9（4），63–70。[Fan, H. W., Chang, L. F., Hsu, Y. J., & Wu, Y. H. (2015). The experience of caring for a patient with antineutrophil cytoplasmic antibody vasculitis and renal involvement who underwent hemodialysis and plasmareplacement. Yuan-Yuan Nursing, 9(4), 63–70.] https://doi.org/10.6530/YYN/2015.4.09

陳妙菁、李淑真、熊德筠（2015）．一位初次腦中風病人復健過程之照護經驗．弘光學報，76，15–26。[Chen, M. C., Lee, S. C., & Hsiung, D. Y. (2015). Nursing experience from caring a first time stroke patient during rehabilitation. Hungkuang Academic Review, 76, 15–26.] https://doi.org/10.6615/HAR.201509.76.02