運用Swanson理論照護一位初次診斷淋巴瘤病人之護理經驗

本文描述一位初次診斷淋巴瘤病人，甫退休預照顧父母即面臨身體不適，住院期間身體症狀持續惡化，歷經多項檢查仍無法獲得確定診斷，且下肢疼痛無法行走需依賴他人照顧，並擔心父母無人照顧及害怕拖累家人，進而產生焦慮，因此引發筆者想深入瞭解之動機。照護期間為2021年7月19日至8月2日，筆者主要以傾聽、觀察、會談、身體評估及病歷查閱等方式收集資料，並以生理、心理、社會及靈性四大層面進行整體性評估及資料分析，確立個案有急性疼痛、焦慮及家庭運作失常之健康問題，於護理過程中運用Swanson關懷理論提供個別性護理措施，包括：非藥物止痛方式及耳穴按壓以緩解急性疼痛；衛教情緒放鬆技巧並搜尋實證文獻運用正念呼吸及病人喜愛的薰衣草精油按摩減緩病人疼痛及焦慮感受；發揮跨團隊資源協助病人尋找合適之社會資源及分享成功案例，降低焦慮感受，亦可與案姐討論父母後續照顧方式，使病人積極正向的面對疾病及後續治療。建議照顧有家庭運作失常健康問題之病人，除同理病人感受、聆聽病人需求，亦可運用跨團隊照護提供相關資源。期望藉此次照護經驗，作為未來醫療人員面對初次診斷癌症患者面臨相同照護議題時之參考依據。

關鍵字

Swanson關懷理論；初次診斷；淋巴瘤

並列摘要

This article describes a patient who was diagnosed with lymphoma for the first time and received care that was delivered in combination with the Swanson's Caring Theory. As soon as he retired to take care of his parents, he faced disease-related physical discomfort. During the hospitalization, his physical symptoms continued to worsen. After multiple examinations, he still could not get a definitive diagnosis. In the end, he was unable to walk because of the lower limb pain and had to rely on others to take care of him, resulting in more anxiety. The patient's concern for his parents' well-being and his fear of dragging down the family motivated the author to learn more. The period of nursing care was from July 19 to August 2, 2021. The author collected data mainly by means of listening, observation, interview, physical assessment, and medical record review followed by a holistic assessment in four aspects: physiology, psychology, society, and spirituality. The data analysis confirmed that the patient had health problems such as acute pain, anxiety and family dysfunction. The Swanson's Care Theory was used to provide individualized nursing measures during the nursing process, including non-drug pain relief methods and auricular pressure to relieve acute pain, emotional relaxation skills and search for empirical literature. The mindfulness breathing combined with the lavender essential oil massage that the patient loved was used to relieve pain and anxiety; the cross-team resources were also provided to help the patient find suitable social resources and learn about other patients' success stories and triumphs, so that patients can feel less anxiety. The patient was encouraged to discuss the long-term care of the parents with his sister so that the patient can face the disease and follow-up treatment positively. It is suggested that in caring for patients with family dysfunction, in addition to empathizing with the patients and listening to their needs, cross-team care should also be used to provide relevant resources. It is hoped that this nursing experience can be used as a reference for other medical personnel when facing the same care issues for first-time cancer patients.

並列關鍵字

Swanson's caring theory ； newly diagnosed ； lymphoma

參考文獻

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