以Swanson關懷理論照護一位初次同時診斷淋巴癌及糖尿病病人之護理經驗

Nursing Experience of Applying Swanson's Caring Theory for a Patient Newly Diagnosed with Malignant Lymphoma and Diabetes Mellitus

葉秉宬(Bing-Cheng Ye) ； 廖珍娟(Jen-Jiuan Liaw) ； 潘雪幸(Hsueh-Hsing Pan)

《長庚護理》 31卷1期 (2020/03) Pp. 90-99

https://doi.org/10.6386/CGN.202003_31(1).0008

摘要

本文運用Swanson關懷理論照護一位初次同時診斷淋巴癌及糖尿病病人克服疾病衝擊與身心不適的護理經驗，護理期間為2018年11月20日至28日，運用觀察、會談、身體評估及查閱病歷等方式，進行身、心、靈、社會的整體性評估，確立個案健康問題為噁心嘔吐、知識缺失及焦慮。以穴位按摩、服用含生薑成分之膠囊及漸進式肌肉放鬆等方式緩解噁心嘔吐；給予安靜的空間引導闡述內心感受及需求，並搭配喜愛的音樂及漸進式肌肉放鬆等方式緩解焦慮，輔以糖尿病自我管理及化療後骨髓抑制衛教，使病人學習疾病自我照護，並以正向積極的態度面對問題及克服疾病衝擊。糖尿病初次診斷病人之自我照護需求易被忽略，糖尿病衛教師介入臨床照護初次診斷糖尿病之病人，可使照護更周到與全面。

關鍵字

Swanson關懷理論 ； 淋巴癌 ； 糖尿病 ； 初次診斷

並列摘要

This article described a nursing experience of applying Swanson's caring theory for a patient newly diagnosed with lymphoma and diabetes mellitus who overcame the disease shock, physical and mental discomfort. We used overall assessment of physical, psychological, social, and spiritual dimensions to assess the patient's health problems through observation, interview, and medical records during the period of November 11 to 20, 2018. We identified the major health problems of the case were nausea and vomiting, knowledge deficiency, and anxiety. We used acupressure, taking the capsule containing ginger ingredients and teaching progressive muscle relaxation to relieve the patient's nausea and vomiting. We also provided the patient a quiet space and guided to express his feelings and needs as well as provided him favorite music and progressive muscle relaxation to relieve his anxiety. Finally, we applied self-management of the diabetes and myelosuppression education to help him face the problems and overcome disease shocks with a positive attitude. Diabetes was a common diagnosis so that it was easily ignored. Therefore, we suggested that the patient who was newly diagnosed with diabetes can be involved with a diabetes nursing educator for comprehensive care.

並列關鍵字

Swanson caring theory ； lymphoma ； diabetes mellitus ； newly diagnosed

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