運用Swanson關懷理論於一位癌末病人死亡焦慮之護理經驗

Applying Swanson's Theory of Caring to Managing Death Anxiety in a Patient With Terminal Colon Cancer

黃雅君(Ya-Chun Huang) ； 梁天麗(Tien-Li Liang)

《榮總護理》 38卷4期 (2021/12) Pp. 429-435

https://doi.org/10.6142/VGHN.202112_38(4).0012

摘要

本文是運用Swanson關懷理論於一位罹患大腸癌男性病人，因確診後疾病快速進展，面對死亡焦慮的護理經驗，照護期間為2018年7月31日至8月29日。筆者運用觀察、會談、理學檢查與實驗室資料方式收集資料，針對病人生理、心理、社會與靈性四大層面進行整體性評估，確立病人有疼痛、死亡焦慮及靈性困擾等護理問題。因病程進展迅速，曾經轉至安寧病房，又因死亡焦慮而反悔要求轉回病房，筆者認為應當運用Swanson關懷理論協助病人安頓身心，經由「了解」病人、「在旁陪伴」傾聽、提供訊息以及「為他做某件事」緩解其身心靈的不適，進一步引導病人訴說面對死亡的看法，「使他能夠」恢復心中平靜，護理過程中協助病人「維持信念」，最後得以善終。8月29日病人在家人陪伴、身心寧靜的狀態下離世。在照護的歷程中，筆者發現當護理人員接受死亡是人生的一部分時，自身才能以更開放的態度與病人談論死亡，並協助渡過臨終的歷程。

關鍵字

疼痛 ； 死亡焦慮 ； 靈性困擾 ； Swanson關懷理論

並列摘要

Swanson's theory of caring was employed for a patient with terminal colorectal cancer who was experiencing death anxiety. Nursing care was provided between July 31 and August 29, 2018. Data were collected through observation, interviews, and physical assessments. The associated health problems included pain, death anxiety, and spiritual distress. Interventions such as ＂knowing,＂ ＂being with,＂ ＂doing for,＂ ＂enabling,＂ and ＂maintaining belief＂ were applied to manage the patient's death anxiety and spiritual distress. In addition, we guided the patient to talk about their view of death, restore their peace of mind, ＂maintain faith＂ during the nursing process, and finally, achieve a peaceful death. On August 29, the patient died in the company of family. By accepting death as a natural part of life, nurses can more easily talk openly about it with patients and guide them through the dying process.

並列關鍵字

pain ； death anxiety ； spiritual distress ； Swanson's theory of caring

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