運用Watson關懷理論於一位重鬱症患者之照護經驗

本文描述一位重鬱症患者長期因婚姻問題及經濟壓力，出現低落情緒、低自尊、對未來及疾病有無望感，以自我傷害方式面對壓力，導致有自殺企圖的護理經驗。護理期間為2009年6月1日至6月22日，以整體性護理評估發現個案主要的健康問題為高危險性暴力行為－朝向自己、個人因應能力失調以及無望感。筆者運用Watson關懷理論與個案建立信任護病關係，陪伴渡過自殺急性期；教導壓力因應技巧以提升調適能力；並鼓勵個案參與疾病衛教團體，分享成功經驗，提供相關疾病認知，使個案對治療產生正向態度，積極配合治療，住院期間無自殺行為發生，且樂觀面對未來的生活。後續追蹤個案出院後情緒可維持穩定，自營飲料攤生意，未再出現自殺行為。

關鍵字

重鬱症；無望感；自殺； Watson關懷理論

並列摘要

The paper described the nursing experience with the patient who suffered from major depression because of long-term marital and economic stresses. She manifested depressed mood, low self-esteem, self-injury, suicidal attempt, and hopelessness. Through holistic nursing assessment in the period of June 1 to 22, 2009, the major health issues were identifies as risk for self-directed violence, ineffective coping, and hopelessness. The ten carative factors of Watson's caring theory were applied into nursing process. The interventions included establishing a therapeutic relationship, encouraging expression of positive and negative perceptions and participation in the education group, accompanying and supporting, and teaching coping strategies. These helped the client safely endure the stage of depressed mood and suicide attempt or ideation, promote her ability in coping and adaptation, enhance interaction with other clients, and increase the knowledge level regarding depression. The client could adhere to treatment plan without suicide behavior, and finally stated that she could be more optimistic toward future. After discharge, she could present stable mood and behave appropriately by telephone follow-up. This paper could serve as a reference of caring for a patient suffering from major depression in order to effectively assist the patient to cope with stresses positively, stay away from suicide, and promote quality of nursing care.

並列關鍵字

major depression ； hopelessness ； suicide ； Watson's caring theory

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運用Watson關懷理論於一位重鬱症患者之照護經驗

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