運用Watson關懷理論於一位反覆入院雙向情緒障礙症病人之護理經驗

A Nursing Experience of Applying Watson's Theory in Caring a Repeatedly-Hospitalized Patient With Bipolar Disorder

10.6386/CGN.202112_32(4).0011

李哲寬(Che-Kuan Li)

Watson關懷理論 ； 反覆入院 ； 雙向情緒障礙症 ； Jean Watson's theory of caring ； repeatedly hospitalized ； bipolar disorder

長庚護理

32卷4期（2021 / 12 / 01）

118 - 127

繁體中文

本文為運用Watson關懷理論，協助一位反覆入院雙向情緒障礙症躁症病人增進壓力因應及自我照護能力之護理經驗。護理期間為2019年11月25日至2019年12月16日，藉由會談、觀察及整體性護理評估收集資料，確立病人主要健康問題有：「睡眠型態紊亂」、「高危險性暴力」及「無效性因應能力」。筆者運用Watson關懷理論十項照護因素於護理措施，藉由關懷本質接納及尊重病人，建立良好治療性關係。出現高危險性暴力行為時，提供支持及矯正性環境保護安全，增進並接受其正負向情緒表達；以系統的科學方式解決睡眠型態紊亂，提供幫助入眠之資訊，並在需要時輔以安眠藥入睡；此外，培養對自己及他人的敏感性，鼓勵辨別適當行為，並藉共享決策模式，討論解決不當壓力因應行為的方法，學習出院後自我管理及尋找生活重心，進而重建生活目標，減少疾病復發可能，期望藉此護理經驗供臨床參考。

This article described a nursing experience of applying Watson's theory in caring a repeatedly-hospitalized bipolar disorder patient to enhance stress coping skills and self-caring ability. The patient's information was collected during the nursing period from November 25 to December 16, 2019 by interviews, observation, and comprehensive nursing assessments. Three major health problems included: ＂disturbed sleep patterns＂, ＂attempting to be aggressive＂, and ＂ineffective coping skills＂. We built a therapeutic nurse-client relationship based on Watson's theory of human caring and provided the humanistic caring to accept and respect the patient. When the patient attempted to be violent, the author not only promoted and accepted the patient's expression of positive and negative feeling, but also provided supportive and corrective environment to ensure the patient's safety. In order to solve the problem of disturbed sleep patterns, we adopted systematic and scientific problem-solving method, such as providing some nursing information to induce falling asleep and administering sleeping medication if the patient needed. In addition, by cultivating the sensitivity to self and to others, the patient was encouraged to distinguish the proper behavior. These approaches allowed us to use the shared-decision making method to assist the patient's self-management and reconstruct her goal of life after discharge. We wish the patient would not experience any relapse after our humanistic nursing interventions and hope the article provide medical staff with a reference for caring repeatedly-hospitalized manic bipolar disorder patients.

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