應用Watson理論於一位食道閉鎖合併氣管食道瘻管新生兒及其家庭之照護經驗

The Nursing Experience of an Esophageal Atresia Combined Tracheoesophageal Fistula Newborn with her Families–An Application of the Watson's Theory

10.6530/YYN.2011.5(2).11

鍾春芳(Chun-Fang Chung)；廖珍娟(Jen-Jiuan Liaw)

食道閉鎖合併食道氣管瘻管 ； Watson理論 ； 家庭護理 ； esophageal atresia combined tracheoesophageal fistula ； Watson's theory ； family-center care

源遠護理

5卷2期（2011 / 11 / 01）

81 - 90

繁體中文

兒科強調以家庭為中心的護理方式，同時重視病嬰與家屬的需求，Watson 理論之十項關懷因子（carative factors）可提供臨床護理的應用。本文是運用Watson理論照護一位食道閉鎖合併食道氣管瘻管新生兒及其家屬之護理經驗。個案是妊娠39週之新生兒，護理期間由2009年10月22日至11月15日。筆者藉由直接照顧、觀察、會談與病嬰及其家屬互動，運用Gordon十一項功能性健康型態評估個案及其家屬之身、心、靈及社會等層面之健康問題，分析個案之健康問題及住院期間家屬所面臨的壓力與需要。確立之護理問題包括：呼吸道清除功能失效、潛在危險性感染、照顧者角色緊張與家庭運作過程改變。筆者運用Watson理論之十項關懷因子提供護理照護，同時滿足個案之生理需求，使個案可於手術後逐漸恢復健康，滿足家屬之心理需要，成功減輕家屬之焦慮，且增加家屬照顧個案之知識及技巧，提高家屬照顧個案的信心和能力。欲藉由此護理經驗，增加新生兒加護病房護理人員重視此類新生兒與家屬之照護，也建議護理人員增加住院期間之護理指導、出院計畫及居家護理追蹤，達到持續性與整體性的照護。

Pediatric nursing emphasizes family-centered care for the needs of both patients and their families.This case study adopted Watson's care theory applying ten care factors (carative factors) for this newborn and the family. The patient was a 39-week gestational age newborn who was admitted to intensive care for surgical repair of tracheal esophageal fistula and esophageal atresia. The nursing care encountered during the 24 days of care with both infant and the family included direct care, observation and interview. The psychological, mental and social dimensions assessment was performed with Gordon 11 functional health patterns assessment. Four nursing problems were identified: (1) ineffective airway clearance, (2) risk for infection, (3) caregiver role strain, and (4) interrupted family processes. Application of Watson's theory fulfilled both the physiological needs of the infant and the psychological needs of the families, enhancing their confidence and ability to provide care for the infant. Application of Watson's caring theory in intensive care unit improves the care experience and enhances discharge planning for continued care.

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