運用Swanson關懷理論於首次腦中風致無望感婦女之急診照護經驗

Applying Swanson's Theory of Caring to Nursing: A Case of a Woman Who Experienced First-Ever Stroke and Subsequent Feelings of Hopelessness

劉靜芳(Ching-Fang Liu) ； 凃懿如(I-Ju Tu)

《榮總護理》 38卷1期 (2021/03) Pp. 71-77

https://doi.org/10.6142/VGHN.202103_38(1).0008

摘要

本文描述一位56歲中年獨立自主女性，正值艾瑞克森心理社會發展理論之「創造對停滯」階段，首次罹患腦中風，面對驟然的右側肢體活動功能障礙，以致生活皆須仰賴他人完成，心理因而產生強烈無望感之急診照護經驗。照護期間為2019年5月7日至5月11日，透過生理、心理、社會與靈性四大層面進行整體性評估，確立病人有身體活動功能障礙、自我照顧能力缺失與無望感之健康問題。筆者運用Swanson關懷理論作為護理措施之架構，循序漸進引導病人參與自我照顧，共同擬定復健計畫並記錄心路歷程，抒發個人情緒，重新認識自我，重拾自我控制權力；幫助家屬提升照顧能力與自信，提早為返家做準備；融合宗教信仰，提供心靈寄託，以重新找回自我價值，重拾正向信念與希望。建議在照護此類病人時，可提供腦中風護理指導單張、醫療照護計畫與他人復健歷程，減少病人與家屬不安感，正向心態面對未來挑戰，願此照護經驗可供大家參考及運用。

關鍵字

Swanson關懷理論 ； 無望感 ； 首次腦中風

並列摘要

This article describes a 56-year-old woman who experienced first-ever stroke in the ＂generativity versus stagnation＂ stage according to Erikson's psychosocial development theory. Facing sudden dysfunction of her right limbs, the patient needed to rely on others for her daily life activities, which resulted in a strong sense of hopelessness. An integrated physical, psychological, social, and spiritual assessment was performed to evaluate health problems associated with the patient's condition, including physical dysfunction, low self-care ability, and hopelessness, during the nursing care period of May 7 to May 11, 2019. The five categories of Swanson's Theory of Caring were applied to this patient's case. We established a harmonious and mutual-care relationship with the patient and her family members, guided the patient in self-care, formulated a rehabilitation plan, and recorded the patient's experiences and thoughts during rehabilitation. We also helped the patient regain self-recognition and self-control, helped to improve the ability and self-confidence of family members in providing care, prepared the family for the patient's early return home, and integrated religious beliefs and provided spiritual sustenance to help the patient regain a sense of self-worth, a positive attitude, and hope. We recommend providing patients and their families with stroke care guidance leaflets, medical care plans, and information on the rehabilitation process of other patients; this would reduce the anxiety of the patient and the patient's family members and help them face future challenges with a positive attitude. We share this case to assist people with similar experiences.

並列關鍵字

Swanson's theory of caring ； hopelessness ； patients with first-ever stroke

參考文獻

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