運用Watson關懷理論於一位肌無力危象病人之護理經驗

The Nursing Care of a Patient with Myasthenic Crisis Based on Watson's Theory of Human Caring

王素貞(Su-Jen Wang)

《馬偕護理雜誌》 9卷1期 (2015/01) Pp. 76-87

https://doi.org/10.29415/JMKN.201501_9(1).0007

摘要

本文乃探討一位原以為是車禍後嚴重胸部損傷使心臟衰竭造成的呼吸衰竭的年輕男性，於外院插管與呼吸器治療，經歷兩次呼吸器脫離失敗，懷疑非心臟問題建議轉院找呼吸衰竭原因，故2011年3月18日轉送至某醫學中心，於神經內科加護病房照護，經由檢查診斷為肌無力症，並有肌無力危象，接受血漿置換術及藥物治療後，症狀漸穩定進而脫離呼吸器之護理經驗。筆者照護期間2011年3月18日至4月8日，運用Watson關懷理論中提出護理以十大關懷照護因子提供個案最佳的照護，確立個案有特定與疾病相關之部分知識缺失、低效性呼吸型態、焦慮與社交隔離等健康問題。關懷護理的運用，使個案了解健康問題及需求，增進對疾病認知，解決身體及心理問題度過危機，指導返家照護知識使提升自我照顧能力，增進對疾病控制的信心；並藉此照護經驗之分享，可以作為護理照護方面之參考。

關鍵字

肌無力症 ； Watson關懷理論 ； 焦慮

並列摘要

This article discusses the nursing care of a young male patient with myasthenic crisis. This young male patient had respiratory failure as result of heart failure due to serious chest injuries after an accident. He had intubation and respiratory therapy in another hospital, however had weaning failure twice. The doctors suspected that the possible reason for the failure was related to non-cardiac problem and recommended referral to identify the underlying reason of his respiratory failure. The patient was transferred to a neurological intensive care unit care of a medical center on March 18, 2011. He was diagnosed as myasthenia gravis and had myasthenic crisis. After the plasmapheresis and medical treatment, his condition gradually stabilized and was able to wean from ventilator. The nursing period was from March 18 to April 18, 2011. The author adopted the 10 caring factors of Watson's Theory of Human Caring to provide the best possible nursing care. The problems included a specific disease-related knowledge deficit, the ineffective breathing pattern and psychosocial problems such as anxiety and social isolation. Using Watson's Theory of Human Caring, the patient understood his health problems and needs, increased the awareness of the disease and solved the crisis of physical and psychological problems. The discharge planning and information was provided to promote self-care skills, which enhanced the patient's confidence on his ability to control disease progression and recovery. The nursing care of the case can be used as the reference of related nursing care in future.

並列關鍵字

myasthenia gravis ； Watson's Theory of Human Caring ； anxiety