運用Watson關懷理論照顧一位胃癌末期病人的護理經驗

The Nursing Care Experience of Applying the Watson's Caring Theory on a Patient with End-Staged Gastric Cancer

蘇郁捷(Yu-Chieh Su) ； 酈欽菁(Chin-Ching Li)

《馬偕護理雜誌》 9卷2期 (2015/07) Pp. 76-89

https://doi.org/10.29415/JMKN.201507_9(2).0007

摘要

本文是敘述一位胃癌末期合併多處轉移病人之護理經驗。癌末病人除須調適癌症帶來的生理不適外，還面臨因無法預測疾病過程而產生對死亡的恐懼。筆者於2014年4月1日至2014年4月8日照護期間，藉由觀察、溝通及身體評估等方式，收集生理、心理、社會及靈性各層面資料，確立其健康問題有疼痛、體液容積過量、低效型呼吸型態、對死亡的恐懼之健康問題。運用Watson關懷理論為照護方針，與病人及家屬建立互相信任的人際關係，接受病人正向及負向的情緒感受，協助放鬆及按摩，以減輕疼痛，改善水腫情形；並與醫療團隊合作，使安詳且有尊嚴地走完人生最後旅程。期望藉此經驗的分享，有助於提升對於癌末患者之照護品質。

關鍵字

胃癌末期 ； 症狀護理 ； 關懷理論

並列摘要

This article describes the nursing care experience of a patient complicated with terminal gastric cancer and metastasis. The patient suffered from the physical symptom distress, unpredictable disease's progression and the fear of death. The duration of nursing care was between of 1st to 8th April, 2014. The clinical data was collected and assessed by observing, interviewing, and physical examination. According to the holistic nursing assessment from physiological, psychological, social and spiritual dimensions, the patient's health problems included pain, fluid volume imbalanced, ineffective breathing pattern and fear of death. Based on the Watson's caring theory, the author developed helping-trusting caring relationships with patient and families in the nursing process. Promoting and accepting the expression of positive and negative feelings helped the patient relaxed in order to relieve pain, and improve edema. Cooperative with the health care team helped the patient with peace and dignity till the end of life. The nursing care experience can be seen as a reference by other clinical nursing staff when enhancing the quality of care of patients with terminal cancer.

並列關鍵字

End-Stage Gastric Cancer ； symptom management ； Watson's caring theory