- 期刊
運用Swanson理論照護一位非預期性流產個案之急診護理經驗
ER Nursing Experience of Caring for a Patient with Unexpected Miscarriage Using Swanson's Theory of Caring
摘要
流產對孕婦及其家人來說是個重大的損失，經歷流產的婦女會有內疚、失落及哀傷的反應，不孕的女性在流產後未能調適將導致憂鬱症的產生。本文旨在描述一位接受人工受孕非預期性流產個案之急診護理經驗，急診照護期間於2016年2月2日19:20分至2016年2月3日00:10分，利用Gordon十一項健康功能評估，歸納個案健康問題有急性疼痛及哀傷。護理過程運用Swanson關懷理論，經由「瞭解」、「在旁陪伴」引導個案說出失去胎兒的感受，傾聽個案真實感受及內心想法，運用「為他做某些事」、「使他能夠」、「維持信念」，與個案及案夫討論減輕疼痛的方法，如:執行深呼吸放鬆、簡單的按摩技巧等個別性的護理措施，在個案面臨胎兒死亡時，提供安靜且獨立的環境，鼓勵個案及案夫可向寶寶道愛及道別，出院後持續以電訪關懷傾聽個案的心裡感受，適時給予正向關懷及鼓勵，與家屬共同協助個案渡過失落哀傷的歷程。建議在急診可規劃獨立空間、建立轉介心理諮商流程、舉辦心理諮商輔導技巧相關訓練，往後必定能給予病人更專業的個別照護與心靈關懷。
並列摘要
Miscarriage is a major loss for pregnant women and their families. Women who experience miscarriage can suffer from guilt, loss and grief. Infertility women who fail to adjust after miscarriage usually lead to depression. This study describes the ER nursing experience of caring for a patient with unexpected miscarriage via applying Swanson's theory of caring. The ER care period is from 19:20 February the 2nd to 0:10 February the 3rd in 2016. The author applied Gordon's 11 Functional Health Patterns, and concludes the health problems of the patient including acute pain and grief. By applying 'understanding' and 'accompany' to guide the case, we can get the patient to express the feeling of losing the fetus, listen to the true feelings of the case and her innermost thoughts. Applying 'helping someone', 'enabling' and 'maintaining belief', the author assigns individualized nursing measures to alleviate pain after discussion with the husband of the case. The author provided the patient with a quiet and independent environment, guided the couples to express their love to the baby and farewell. After discharged from the hospital, continued with phone interview to listen to the case, and get her to express her feeling about losing the fetus, provide positive caring and encouragement, as well as incorporate the patient's family to jointly help the patient overcome loss and sorrow. ERs are advised to assign an independent space, develop referral and furthered the consultation procedures. Furthermore offer the training of consultation and counseling skills to provide similar cases with more professional and individualized care in the future.