運用Watson關懷理論照護一位鼻咽癌病人之護理經驗

Applying the Watson's Theory on a Patient with Nasopharyngeal Cancer

10.6880/TJON.202006_20(1).04

蘇慈棉(Tzu-Mien Su)；陳幼貴(Yu-Kuei Chen)

Watson關懷理論 ； 鼻咽癌 ； 疼痛 ； 跌倒 ； 無力感 ； Watson's Theory ； nasopharyngeal cancer ； pain ； risks for falls ； powerlessness

腫瘤護理雜誌

20卷1期（2020 / 06 / 01）

51 - 62

繁體中文

本文描述一位中壯年鼻咽癌病人因疾病及治療，面臨身心靈衝擊之護理經驗。護理期間為2017年6月28日至7月5日，此次因左鼻咽腫瘤變大並侵犯顱底和顱內，疾病控制不良，疼痛無法控制，影響生活及工作，覺得治療無望，不願與他人互動，引發筆者想深入探討之動機。依生理、心理、社會、發展及靈性層面進行整體性評估，確立病人有「疼痛」、「潛在危險性損傷－跌倒」及「無力感」等健康問題。護理過程以Watson關懷理論為基礎，提供個別性護理措施，發展以助人／信任的關係，並主動提供相關醫療訊息、協助滿足生理基本的需要、提供支持性、保護性的心理、生理、社會文化及靈性的環境。運用醫療團隊合作外，在照顧過程中，提供個案舒適護理技巧，運用藥物及非傳統止痛藥物方式，減輕疼痛不適，針對家屬給予個別化指導，建立共同照護責任；藉由關懷、傾聽、同理及心理師、精神科醫師介入，與個案及家屬建立互相信任的關係，協助處理情緒問題，讓個案獲得舒適照護，肯定自我價值，也主動願意配合醫療處置，回歸正常社會生活，期許藉此經驗的分享，有助於對於癌症患者之靈性照護品質之重視，實現全人照護精神。

This article describes the experience of caring for a nasopharyngeal cancer patient under physical and mental impacts from the cancer treatment. From June 28 to July 5 in 2017, the disease progressed in patient's left nasopharynx to where he couldn't work under the poorly controlled pain and began to feel hopeless and unwilling to interact with others. Therefore, the author was motivated to make an in-depth exploration of nursing assessment. By gathering the information about the patient's physical, psychological, sociological and spiritual status, the author was able to identify some health problems: pain, risk of fall and sense of powerlessness. Based on the Watson's Theory, the author provided the individualized nursing intervention, developed a trusting relationship, offered medical information to meet the physical, psychological, social and spiritual needs of the patient. In addition to the collaboration among the healthcare teams, the author offered individualized therapy for comfort, applied medication and holistic painkiller to reduce the pain. Through caring, listening, and empathy, psychologists and psychotherapists also helped the patient and family to build new understanding, address emotional issues, and encouraged cultivation of the patient's self-esteem. By sharing this experience, the author hopes to draw attention to the spiritual quality and implementation of holistic care.

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