- 期刊
運用Watson關懷理論照護一位脊椎損傷合併肺炎病人之照護經驗
Nursing Experience of the Watson's Caring Theory applied to a Spinal Cord Injury Patient Suffering from Pneumonia
摘要
本文描述一位脊椎損傷術後病人出院後發生肺炎導致呼吸衰竭之護理經驗，面對突如其來的失能及身體功能重大改變對未來產生無望感，引發筆者探討之動機。護理期間為2017年12月16日至12月26日，透過觀察、溝通、病歷回顧及身體評估收集資料，運用生理、心理、社會靈性進行整體評估，發現個案有身體活動功能障礙、呼吸道清除功能失效、無望感之護理問題；護理過程中採用Watson關懷理論，主動關懷並協同家屬鼓勵個案抒發情緒、表達感受並給予陪伴及正向回饋，另鼓勵個案參與照護以維持身體活動功能及增加控制感，最終協助個案脫離呼吸器並以正向態度面對自我，期望藉此經驗分享當照護因疾病進展而產生無望感之個案時，於護理過程中運用關懷理論提供照護。
並列摘要
In the face of sudden disability and major changes in physical function, any patient might suffer from the feeling of hopelessness for the future. This case report describes a nursing experience with a patient who had a spinal cord injury and suddenly suffered respiratory failure within a week after discharge from the hospital. A nursing process was conducted from December 16 to 26, 2017 and collected information via the method of observation, communication, chart review and physical assessment. Based on the framework of physical, psychological and social spirituality to conduct a holistic assessment for the patient, it was identified that the patient had problems with impaired physical mobility, ineffective airway clearance, and hopelessness. Watson's caring theory was applied to the nursing process by encouraging the patient to express the emotion of hopelessness, and by providing companionship and positive feedback with the patient and his family. Besides, we conducted an encouraging strategy and motivated the patient to participate in daily care to maintain physical activity and increase self-esteem. Finally, the patient succeeded in being weaned from mechanical ventilation, facing himself and the disability with a positive attitude. This nursing experience can benefit nursing staff by using caring theory to care for a patient with hopelessness caused by illness progress and assist the patient to develop a positive attitude toward treatment and the future.