關懷理論於一位慢性脫髓鞘多發性神經病變病人之護理經驗

A Nursing Experience from Applying Watson's Caring Theory on a Patient with Chronic Inflammatory Demyelinating Polyneuropathy

10.29494/LN.201903_20(1).0005

許維真(Wei-Jhen Hsu)

慢性脫髓鞘多發性神經病變 ； Watson關懷理論 ； Chronic inflammatory demyelinating polyneuropathy ； Watson'scaring theory

領導護理

20卷1期（2019 / 03 / 01）

65 - 79

繁體中文

本文是描述協助一位慢性脱髓鞘多發性神經病變病患之護理經驗，護理期間為2015年3月11日至2015年3月26日，此疾病會使感覺異常及運動功能漸進退化，因而造成失能；因家中原已有位智能障礙兒子，病患生病使家中頓失經濟來源，造成家庭負荷；筆者藉由會談、觀察、身體評估、臨床檢查等資料收集，運用整體性護理評估確立主要共有三個健康問題：高危險性傷害／跌倒、無望感、家庭因應能力失調，故以Watson關懷理論中提出十項關懷因子提供病患最佳的照護，護理過程中藉由主動關懷及傾聽，提供疾病與治療相關衛教以減輕對預後的不確定感，提升對疾病控制的信心，鼓勵表達內心感受加強支持系統，並設計個別化床邊活動與家屬協同復健，使病患及家庭能早日恢復正常運作，提供返家後續照護規劃及長期照顧資源，提升自我照護技能並降低照顧者負擔；冀望藉此照護經驗分享，提供護理同仁未來照護此類病人之參考。

This article recounts an experience with the application of Watson's caring theory for a Chronic inflammatory demyelinating polyneuropathy patient. The nursing period was from the 11th to 26th of March in 2015. This disease could cause abnormal sensations, motor functions degenerate gradually and hence lead to disability. The patient has a mentally retarded son, his illness leads to abruption of financial resources and add on to his family's burden. Data were collected through interview, observation, physic al assessment, and clinical examination. The use of holistic nursing assessment identified three main issues: the potential risk of falling, the feeling of hopelessness, and ineffective copping with family. Therefore, the author adopted the ten caring fact ors of Watson's caring theory to provide the best possible nursing care. The author offered disease and treatment-related health education to alleviate uncertainty of prognosis and to enhance confidence on his ability to control disease progression and recovery with initiative attention and listening to the patient. The author also encouraged him in expressing inner feelings with family members to consolidate support system and also designed personalized bedside activities accompanied with family in the rehabilitation programs. Additionally, discharge planning was provided with long -term care resources, and promoting his self-care skills to help relieving the working loads of the primary caregiver. By sharing this case report, it hopefully serves as a reference to medical personnel of nursing care to similar cases in the future.

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