運用Watson關懷理論照顧一位食道癌及結腸癌並存患者

本文是運用Watson關懷理論照顧一位初診斷食道癌及結腸癌並存患者，個案此次因結腸癌入院進行手術治療，術後個案除面對傷口急性疼痛，也擔心後續治療與面對經濟等問題，更因同時發現罹患食道癌而對人生感到無希望。照護期間為2017年3月26日至4月15日，筆者主要以傾聽、觀察、會談、及病歷查閱等方式收集資料，以整體性評估方式評估個案之生理、心理、社會、靈性四層面，確立個案有急性疼痛、焦慮、無望感之三項護理問題，護理過程中利用Watson關懷理論給予相關護理措施，包括：教導非藥物止痛策略及情緒放鬆技巧、傾聽個案及案妻的擔憂、評估身心不適狀況、協助尋找資源及分享成功案例等，以幫助個案緩解急性疼痛問題，並協助其能主動自我表達其感受，並適應疾病治療不適、減輕經濟負擔降低情緒困擾，積極正向的面對疾病及後續治療，以緩解個案的焦慮與焦望感。期望藉此照護經驗，作為未來醫療人員對同時罹患多癌別患者面臨相同照護議題時之重要參考依據。

關鍵字

癌症； Watson關懷理論；急性疼痛；焦慮；無望感

並列摘要

The case report described the experience of applying Watson's Caring theory to take care of a patient with a primary diagnosis of esophageal cancer and colon cancer. The patient underwent surgery for colon cancer. During hospitalization, the patient suffered from acute wound pain from surgery, was worried about follow-up treatment and financial problems, and felt hopeless due to also having esophageal cancer. Nursing care was provided in a medical ward from March 26 to April 15, 2017. Information was collected through listening, observation, interviews, and medical records review. Physical, psychological, social, and spiritual aspects of the patient were assessed and the health problems identified included: acute pain, anxiety, and hopelessness. By implementing the Watson's Caring theory, our strategies included teaching non-medication analgesia, listening to the patient's and his wife's concerns, assessing physical and mental symptoms, providing relaxation skills, and helping them to find resources and sharing successful cases. These strategies were useful in helping the patient reduce pain, actively expressing his feelings, coping with anti-cancer treatment, and reducing emotional distress which would enable him to positively face his disease and follow-up treatment. They effectively reduce the patient's anxiety and hopeless feeling. This nursing care experience can serve as an important reference for future care providers who deal with similar issues when caring for patients with multiple cancers.

並列關鍵字

cancer ； Watson's Caring theory ； acute pain ； anxiety ； hopelessness

參考文獻

衛生福利部(2017，6 月19 日)．105 年死因統計結果分析．取自http://dep.mohw.gov.tw/DOS/lp-3352-113.html [Ministry of Health and Welfare. (2017, June 19). 2016 statistics of causes of death. Retrieved from http://dep.mohw.gov.tw/DOS/lp-3352-113.html]