運用Watson關懷理論照顧一位反覆心室頻脈病患之經驗

Application of Watson's Theory of Human Caring to a Patient with Recurrent Ventricular Tachycardia: A Case Report

洪美玲(Mei-Ling Hung) ； 陳淑雅(Shu-Ya Chen) ； 王妍惠(Yen-Hui Wang)

《高雄護理雜誌》 40卷2期 (2023/08) Pp. 142-152

https://doi.org/10.6692/KJN.202308_40(2).0012

摘要

本文描述照顧一位反覆心室頻脈發作，須不斷接受電擊治療患者的加護經驗。自2020年7月1日至7月15日護理期間，以Watson十項關懷理論為護理服務的核心，運用觀察、筆談、會談及實際照護，確立個案護理問題包括：因心律改變造成的心輸出量減少、致命性心律不整反覆發作而造成情緒上的創傷後反應、以及皮膚完整性受損等護理問題。在護理過程中，經由提供個案個別性的護理措施，協助維持正常的心輸出量、應用同理心及陪伴傾聽的技巧減輕個案之創傷後反應情緒，並協助個案面對疾病的發展，克服心理障礙而能接受植入式去顫器治療，及提供電擊後皮膚損傷的照護，在醫療團隊共同努力之下，病情得以緩解。筆者期望能藉此經驗，提供重症單位護理人員照護此類病人時的參考。

關鍵字

心室頻脈 ； Watson關懷理論

並列摘要

This article describes the nursing care for a patient with recurrent ventricular tachycardia under repeat defibrillation treatment. During July 1st to 15th in 2020, we identified issues including cardiac output reduction from heart rate alteration, post-traumatic stress disorder (PTSD) from fatal related arrhythmia, and impaired skin integrity based on observation, written communication, consultation and actual care outlined in Watson's caring theory of ten cares as the core of nursing service, with these issues being addressed during care. Cardiac output was maintained at normal levels through individual nursing care, while PTSD was alleviated through empathy, companionship and listening. Care was taken to help the patient understand disease progression and manage anxiety related to installation of an implantable cardioverter defibrillator (ICD) and impaired skin integrity care after defibrillation treatment, and through all the medical team's effort, the patient was stabilized. The author hopes this experience could be a reference for ICU nurses with patients suffering from recurrent ventricular tachycardia.

並列關鍵字

ventricular tachycardia ； Watson's caring theory

參考文獻

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