運用Swanson關懷照顧理論於行子宮全切除術病人之護理經驗

Nursing Experience of Applying Swanson's Caring Theory to Patients Undergoing Total Hysterectomy

陳涵玲(Han-Ling Chen)；趙家伶(Chia-Ling Chao)

Swanson關懷照顧理論 ； 急性疼痛 ； 現存性感染 ； 身體心像紊亂 ； Swanson's caring theory ； post total hysterectomy ； acute pain ； existing infection ； disturbed body image

若瑟醫護雜誌

18卷1期（2024 / 06 / 01）

38 - 50

繁體中文;英文

本文探討一位38歲女性因子宮平滑肌惡性肉瘤併腹內感染行子宮全切除術及腸修補手術後建置橫結腸腸造口術術後之護理經驗。護理期間於2022/05/05至2022/5/20，藉由直接照護、會談、觀察、身體評估等方式進行資料收集，並依據Gordon十一項健康功能型態評估確立有急性疼痛、現存性感染及身體心像紊亂等健康問題。筆者運用Swanson關懷照顧理論，維持舒適臥位，教導放鬆技巧或轉移注意力進而緩解疼痛；採無菌技術協助傷口換藥並保持乾燥，監測傷口及生命徵象變化，抗生素使用並追蹤感染指數，維持住院期間感染控制。傾聽其對身體外觀與功能改變之感受，鼓勵參予傷口照護、利用鏡子觀看並撫摸身體改變的部位，以溫和態度討論對疾病的看法，並與個案討論相關的照護問題，以提升疾病照護之認知，進而接納事實。建議運用跨領域團隊照護功能，提供完善且適切的銜接服務及門診交班系統，亦透過院內網路建構社交網站，藉由病友間互相鼓勵，達到心靈上的寄託，已提供更完善的全人照護。

This article discusses the nursing experience of a 38-year-old woman who underwent total hysterectomy, bowel repair, and transverse colostomy for malignant uterine smooth muscle sarcoma complicated by intra-abdominal infection.During the nursing period, from 2022/05/05 to 2022/5/20, data collection is performed by direct care, conversations, observation, physical assessment and other methods, and establishes acute pain, existing infection based on the Gordon's 11 functional health patterns. And health problems such as body image disturbance. The author uses Swanson's caring theory, Maintain comfortable lying positions, teach relaxation skills or transfer attention to relieve pain; use sterile technology to help wounds change dressing and maintain dryness, monitor the changes in wounds and vital signs, use antibiotics and track the infection index, Maintain infection control during hospitalization. Listen to the feelings of the body's appearance, encourage participation in wound care, use the mirror to watch and touch the body's changes, Discuss your views on disease with a gentle mind, and discuss related care issues related to the case to enhance the cognition of disease care, to improve awareness of disease care and accept the current condition.It is recommended to use Interdisciplinary team care functions to provide comprehensive and appropriate connection services and outpatient delivery systems. It also constructs social networking websites through the internet to construct social networking sites to encourage each other by patients to achieve spiritual sustenance, has improved holistic care.