運用Swanson關懷理論照護一位脊髓腫瘤復發癌症病人無望感之護理經驗

Nursing Experience in Utilizing Swason's Caring Theory for Hopelessness in a Cancer Patient with Recurrent Intramedullary Tumors

10.29494/LN.201809_19(3).0004

胡嘉桂(Chia-Kuei Hu)；林佩昭(Pei-Chao Lin)

Swanson關懷理論 ； 希望措施 ； 脊髓腫瘤 ； 復發性癌症 ； Swanson's caring theory ； hope intervention ； intramedullary tumors ； recurrent cancers

領導護理

19卷3期（2018 / 09 / 01）

34 - 49

繁體中文

本文敘述一位黑色素神經鞘瘤患者，面對脊髓腫瘤不斷復發開刀，因病情惡化而有活動障礙甚至無望感產生的護理經驗。筆者於2017年03月01日至03月15日護理期間，藉由Swanson關懷照護策略為指引進行會談、觀察及直接照護等方式收集生理、心理、社會、靈性需求，發現主要護理問題包括：疼痛、無望感、身體活動功能障礙。照護過程中以Swanson關懷理論為主軸，包括了解、在旁陪伴傾聽、為他做某些事、使他能夠及維持希望信念，灌注個案希望並建立靈性支持，並以Herth及Duggleby提出的希望措施用以改善病人無望等負面影響，協助因應疾病。這些措施改善病患生理及心理的健康並達到心靈安適。

This article describes the nursing experience of a male patient diagnosed with melanotic schwannoma who had several operations as recurrences of cancer developed. The problems of impaired physical function and hopelessness caused by illness deteriorated. Between March 1st and 15th of 2017, the nurse collected data of patient's physical, psychological, social and spiritual needs through interviews, observations, and direct contact using the guidelines of Swason's caring strategies. The nurse discovered the major nursing issues with the patient included pain, hopelessness and impaired physical function. The nurse provided the interventions consist ＂knowing＂, ＂being with＂, ＂doing for＂, ＂enabling＂, and ＂maintaining belief＂. The nurse base on Swanson's caring theory to helped the patient to stay positive and established social supports. Additionally, the nurse used the hope interventions suggested by Dr. Herth and Dr. Duggle to refine the patient's negativities caused from the symptom of cancer. These interventions helped the patient improve his physical and hence psychological health and the spiritual well-being.

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