運用Watson關懷理論照顧失能老人及其主要照顧者之護理經驗

A Nursing Experience of an Elderly with Disability and the Primary Caregiver Using Watson's Caring Theory

10.6974/TCNJ.201202.0127

許芳惠(Fang-Hui Hsu)；林麗娟(Li-Chuan Lin)；宋惠娟(Huei-Chuan Sung)

失能 ； 老人 ； 主要照顧者 ； 護理 ； Watson關懷理論 ； disability ； elder ； nursing ； primary caregiver ； Watson's Caring Theory

志為護理-慈濟護理雜誌

11卷1期（2012 / 02 / 01）

119 - 128

繁體中文

本文為運用Watson關懷理論照顧一位失能老人及其主要照顧者之護理經驗。筆者於門診護理一位因膝關節退化而行動不便的失能老人，因活動功能受限，所以在日常生活活動上非常依賴主要照顧者，在門診回診中，發現主要照顧者表現出不耐煩、焦慮、挫折、無助等情形。觀察及會談後發現此老人的主要護理問題為：（1）身體活動功能障礙及（2）家庭因應能力失調；而主要照顧者的護理問題為照顧知識缺失。護理過程中藉由關懷、陪伴、傾聽，適時給予鼓勵及支持，提供此老人及主要照顧者護理指導、及長期照顧資源訊息及轉介等，促進此老人活動功能及主要照顧者的照顧知識及技能。筆者藉由鼓勵家庭成員共同分擔照顧任務並促進家庭正常功能的運作。筆者也教導主要照顧者運用長期照顧資源來協助照顧此老人並緩解主要照顧者的負荷。在護理照護中運用Watson理論的原則可促進老人及主要照顧者的身體、心理、靈性及社會的健康。（志為護理，2012；11：1，119－128）

This article described a nursing experience for an elderly patient with disability and the primary caregiver using Watson’s Caring Theory. The author cared for an elderly outpatient with knee joint degeneration and impaired mobility, and found the patient depended heavily on the primary caregiver. The primary caregiver exhibited signs of impatience, anxiety, frustration, and helplessness during outpatient visits. By observing and interviewing the patient and the caregiver, the following nursing problems regarding the elderly patient were identified: (1) impaired physical mobility; and (2) ineffective family coping; the nursing problem regarding the primary caregiver was identified as care knowledge deficiency. During the nursing process, the author assisted in improving the elderly patient’s mobility and the caregiver’s care knowledge and skills through caring, accompanying, listening, and providing encouragement, emotional support, nursing instructions, and information and referral regarding long-term care resources. The author encouraged the patient’s family members to share caring responsibilities and to improve family function. The author taught the primary caregiver to apply for long-term care resources for caring the patient and relieving the caregiver’s burden. The patient and the primary caregiver’s physical, mental, spiritual and social health were promoted by implementing the principles of Watson’s theory in nursing care. (Tzu Chi Nursing Journal, 2012; 11:1, 119-128)