運用Swanson關懷照護理論照顧一位COVID-19病人之護理經驗

Nursing Experience of Applying Swanson's Caring Theory to a Patient with COVID-19

楊雅淇(Ya-Chi Yang) ； 胡嘉桂(Chia-Kuei Hu) ； 武香君(Hsiang-Chun Wu)

《領導護理》 21卷4期 (2020/12) Pp. 9-24

https://doi.org/10.29494/LN.202012_21(4).0002

摘要

本文主要探討一位確診嚴重特殊傳染性肺炎（COVID-19）個案，因傳染性疾病、學業中斷及因疾病需被嚴格隔離所引發的生理、心理、社會等層面的問題，進而呈現相關之照護經驗。於2020年3月23日至4月23日照護期間，以Gordon十一項功能性健康型態評估為指引，並運用觀察、會談、身體評估等方法收集資料，確立健康問題有：（1）現存性感染；（2）因嚴格的隔離措施而衍生出社交隔離；（3）因疾病帶來不確定感、擔心家人感染、學業中斷及輿論壓力而產生焦慮。護理過程中筆者以Swanson關懷照護理論主動關懷、經驗分享及有效的溝通等技巧，建立良好護病關係，並不斷透過醫療團隊的合作討論，主動提供相關訊息，以個別性的護理措施，使個案於住院期間感受被關懷與獲得安全感，引導個案以正向態度面對此次疾病，進而協助個案解決護理問題。感染新型冠狀病毒病人除了生理的不適外，心理的變化亦需要被重視，期許藉由此個案照護經驗分享，提供護理人員對於此類病人之整體性照護參考。

關鍵字

嚴重特殊傳染性肺炎 ； 焦慮 ； 社交隔離 ； Swanson關懷照護理論

並列摘要

This article discusses the experience of nursing care from looking after a patient with COVID-19. She was suffering from the physical, psychological, and social complications due to infectious diseases that lead to school interruption, and strict isolation. During the care period of isolation - March 23th to April 23th, 2020 - the author used Gordon 11 Function Health Patterns as guidelines, and collected data through observation, interviews, and physical assessments. Assessments confirmed that the problems faced by the patient includes: (1) existing infections and (2) social isolation problems related to strict isolation measures and (3) anxiety related to uncertainties about disease prognosis, fear of family infection, school interruption, and public opinion pressure. During the caring process, the author applies Swanson's caring theory to active caring, experience sharing, and applies effective communication skills to establish a good therapeutic interpersonal relationship. Through the cooperation and discussion of the medical team, the author proactively provided relevant information and distinctive care to help her feel caring and safe guarded during hospitalization, face the illness with a positive attitude, and hence solving caring issues. In addition to the physical discomfort of patients infected with the new coronavirus, psychological changes also need to be taken seriously. We hope this experience is useful and can be used as a reference for caring similar patients in the future.

並列關鍵字

COVID-19 ； anxiety ； social isolation ； Swanson's caring theory

參考文獻

徐莞雲、陳筱瑀（2008）．焦慮的概念分析．志為護理─慈濟護理雜誌，7(3)，65-70。https://doi.org/10.6974/TCNJ.200806.0065

陳曉琦、周汎澔（2010）．Watson 人性化關懷照護理論與Swanson關懷照護理論之比較．護理雜誌，57(3)，86-92。https://doi.org/10.6224/JN.57.3.86

許藏菁、吳佳鉛、賴霈妤、薛伶珊、賴怡因、柯乃熒（2020）．照顧一位COVID-19 病人在隔離期間之護理經驗．護理雜誌，67(3)，111-119。https://doi.org/10.6224/JN. 202006_67(3).15

Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet, 395(10227), 912-920. https://doi.org/10.1016/S0140-6736(20)30460-8

Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., ... Feng, Z. (2020). Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. The New England Journal of Medicine, 382(13), 1199–1207. https://doi.org/10.1056/NEJMoa2001316