運用Swanson關懷理論照顧一位白血病移植後婦女之護理經驗

本文係描述運用Swanson關懷理論照顧一位罹患急性骨髓性白血病婦女接受異體造血幹細胞移植後，因治療過程的不順遂及長期住院對照顧小孩感到力不從心之照護經驗。照顧期間自2019年7月24日至2019年8月25日，筆者透過觀察、會談、身體評估及病歷查閱等方式收集資料，經由Gordon十一項健康功能型態評估工具進行整體性評估，評估個案生理、心理、靈性及社會層面，確立有疼痛、身體心像紊亂、親職角色衝突等3項健康問題。照護期間運用Swanson關懷理論的了解、在旁陪伴、為他做某些事、使他能夠、維持信念為照顧方針，與個案建立信任的護病關係，透過陪伴、傾聽及主動關懷，提供護理專業技能，相關的醫療訊息及計畫，減輕疼痛的生理不適及身體外觀改變的心理衝突，分享同為母親的經驗，擬定親子計劃，轉介腫瘤心理師，維持家庭功能運作，協助個案以正向的態度重拾扮演母親角色的信心。筆者觀察臨床大部分癌症病人的情緒無法得到紓壓，建議醫院的癌症病房應有一位專責腫瘤心理師，透過與病人持續性的關係建立，讓病人以正向思考面對治療的挑戰，減輕心理的衝擊，藉由提供跨領域專業團隊合作的持續性心理照護，達到全人醫療理念。

關鍵字

Swanson關懷理論；白血病；異體幹細胞移植；身體心像紊亂

並列摘要

This article describes the experience of caring for a woman suffering from acute myeloid leukemia and receiving allogeneic hematopoietic stem cell transplantation by using Swanson's caring theory. The treatment process was not stable and the long-term hospitalization made her feel unable to take full care of her child. During the caring period from July 24 to August 25, 2019, the researcher collected data through observations, interviews, physical assessments and medical records review, and conducted a holistic assessment through Gordon's eleven health-function assessment tools to assess the physiology of the subject. For the subject's psychological, mental, spiritual, and social levels, three health problems were identified including pain, disturbance of body and mental image, and parental role conflict. During the caring period, the researcher used Swanson caring theory to accompany the patient, do certain things for her, and enable her to maintain her beliefs in the caring policy while reducing the physical discomfort of pain and psychological conflict in the change of physical appearance. The researcher also shared the experience of being a mother and developingand maintaining the function of family in the household, thereby helping the subject to regain confidence in playing the role of the mother in a positive attitude.

並列關鍵字

Swanson's Care Theory ； Leukemia ； Allogeneic stem cell transplantation ； body image disturbance

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