運用Watson關懷理論協助一位大腸癌末期病人善終之護理經驗

Nursing Experience of Using Watson's Caring Theory to Assist a Patient With Colorectal Cancer in Hospice Care

10.6142/VGHN.202303_40(1).0008

朱庭嬉(Ting-His Chu)；張玉官(Yu-Kuan Chang)；林鎂喻(Mei-Yu Lin)

Watson關懷理論 ； 大腸癌 ； 預期性哀傷 ； 無望感 ； Watson's caring theory ； colorectal cancer ； anticipatory grief ； hopelessness

榮總護理

40卷1期（2023 / 03 / 01）

74 - 80

繁體中文;英文

本文乃描述運用Watson關懷理論照顧一位大腸癌末期病人善終之護理經驗。護理期間2020年11月30日至12月14日，以觀察、會談、身體評估等技巧，並運用Watson關懷理論、安寧善終理念歸納出病人有疼痛、無望感及家屬預期性哀傷等問題。照護期間除了減輕病人生理上之不適，更引導病人說出對死亡的看法及抒發情緒，協助找到人生意義與價值，提升自我正向感，改善無望感，降低預期性哀傷，使病人及家屬內心平安，讓其有勇氣去面對死亡，達到全人、全家之照護，另外建議多增加同理心、宗教靈性關懷之在職教育，讓護理人員在照護癌末病人時能更深入靈性關懷，實現全人照護之理念，並冀望藉由此照護經驗提供爾後臨床照護此類病人之參考。

This article describes our nursing experience of caring for a patient with colorectal cancer in hospice care. It uses Watson's theory of human science and human care to help the patient. Nursing care was provided from November 30, 2020, to December 14, 2020. Relevant data were collected through interviews, listening, and physical examination. Physical, psychological, social, and spiritual assessments were performed. The following problems were identified: pain, hopelessness, and anticipatory grief. On the basis of Watson's caring theory and the concept of a good death, emotional support was provided to the patient in addition to alleviating the patient's physical discomfort. The patient could express sorrowful emotions and perspectives on death. Care was focused on helping the patient to find meaning in life, enhance self-positivity, and alleviate feelings of hopelessness. Patients in hospice care require empathy and spiritual care; thus, relevant training should be provided to nurses so that they can offer holistic care to such patients and their family members. Our experience may facilitate the development of care guidelines for patients in hospice care.

1. 余琇楓,簡翠薇,陳依琳,陳美麗(2020)。運用輔助療法於長期照護機構乳癌末期長者的護理經驗。志為護理 - 慈濟護理雜誌，19(6)，115-124。
   連結：
2. 李佳欣,鄭婉如,馬瑞菊(2016)。一位生命末期患者選擇撤除維生醫療之護理經驗。安寧療護雜誌，21(1)，75-87。
   連結：
3. 黃千毓,吳孟霖,任東輝(2017)。下背痛的鑑別診斷與針灸治療。中華針灸醫學會雜誌，20(3-4)，39-53。
   連結：
4. Kumar, P.,Wright, A. A.,Hatfield, L. A.,Temel, J. S.,Keating, N. L.(2017).Family perspectives on hospice care experiences of patients with cancer.Journal of Clinical Oncology,35(4),432-439.
5. Phongtankuel, V.,Burchett, C. O.,Shalev, A.,Adelman, R. D.,Prigerson, H.G.,Czaja, S. J.,Dignam, R.,Baughn, R.,Reid, M.C.(2019).Perceptions of a home hospice crisis: An exploratory stdy of family caregivers.Journal of Palliative Medicine,22(9),1046-1051.
6. Sarvizadeh, M.,Ghasemi, F.,Tavakoli, F.,Khatami, S. S.,Razi, E.,Sharifi, H.,Biouki, N. M.,Taghizadeh, M.(2019).Vaccines for colorectal cancer: An update.Journal of Cellular Biochemistry,120(6),8815-8828.
7. Watson, J.(1990).Caring knowledge and informed moral passion.Advances in Nursing Science,13(1),15-24.
8. 柯美如,陳美君,洪敏瑛(2020)。照顧一位大腸癌末期疾病進展快速病人之善終護理經驗。台大護理雜誌，16(2)，41-52。
9. 梁詩柔,朱盈蓉,廖婉君(2020)。照護一位大腸癌末期病人臨終之護理經驗。高雄護理雜誌，37(1)，137-149。
10. 陳曉琦,周汎澔(2010)。Watson 人性化關懷照護理論與 Swanson 關懷照護理論之比較。護理雜誌，57(3)，86-92。
11. 衛生福利部 (2021，8 月 19 日 )．109 年國人死因統計結果。https://www.mohw.gov.tw/cp-5017-61533-1.html