協助一位心臟移植手術後病患壓力因應之護理經驗

Nursing Care of a Patient Coping with the Stress of Heart Transplantation

蕭慧娟(Hui-Chuan Shiao) ； 黃秀梨

《領導護理》 8卷2期 (2007/12) Pp. 47-56

https://doi.org/10.29494/LN.200712.0006

摘要

本文探討一位心臟移植患者手術後壓力因應的護理經驗，評估個案壓力源有：(1)身體不適、(2)擔心出現合併症、(3)擔心未知預後、(4)擔心經濟負擔、(5)對捐贈者的虧欠。個案初期面對壓力的因應行爲有：(1)遵循復健計畫、(2)妥協、(3)提出問題尋找支援。針對個案的壓力因應行爲表現，提供護理措施包括： (1)增強動機、提供資源、(2)傾聽、支持、引導表達、協助減輕壓力刺激源及介紹支持團體、(3)鼓勵架構遠景及評估遠景執行的困難、(4)鼓勵重要親友的支持、(5)鼓勵回顧等待移植前的感受及正向引導，協助轉化虧欠感爲支持自己珍惜生命的力量。護理措施介入後，個案的因應行爲有：(1)承諾並遵循醫療計畫、(2)調整個人情緒、(3)往好處想、(4)尋找家人親友的支持、(5)尋找社會資源協助、(6)對自己有新的期許、(7)重新賦予意義、(8)尋找靈性力量的支持。此護理經驗協助個案有效因應此次壓力事件，並協助個案將此事件之感受重整至自己未來生活中，進而影響生命價值及信念。

關鍵字

心臟移植 ； 壓力 ； 因應 ； 護理

並列摘要

This paper was exploring the nursing experience in assisting patients coping with the stress of cardiac transplant. Several stressors were revealed: (1) physical discomfort (2) worries about the complications (3) unknown prognosis of heart transplant (4) economic burden (5) feeling sorry for the donor. At the beginning, some coping strategies were used by patients and these strategies include: (1) obey the rehabilitation regime (2) compromise (3) call for help. Some nursing interventions can be offered as follows: (1) promote motivation and provide needed resources (2) listening, supportive and leading to expression (3) introduce the support groups (4) encourage family to give support (5) encourage reflect back the feeling prior to cardiac transplant. After the nursing intervention were provided, patient's coping strategies shift to: (1) commitment to obey the rehabilitation regime (2) adjust their emotion (3) positive thinking (4) looking for the help from families (5) seeking for social resource (6) set a new goal for himselves (7) set a new meaning of life (8) seeking for spirit support. The patient was therefore successfully directed to integrate his experience of heart transplant into his feelings and future life for resulting in excellent adaptation.

並列關鍵字

heart transplantation ； stress ； coping ； nursing