一位薦椎脊索瘤患者之護理經驗

Applying Watson's Caring Theory in the Nursing Experience of a Patient with a Sacral Chordoma

10.6740/NTUHJN.202101_17(1).0010

廖晨瑾(Chen-Jin Liao)；陳美玲(Mei-Ling Chen)

脊索瘤 ； 不確定感 ； 焦慮 ； Watson關懷理論 ； chordoma ； uncertainty ； anxiety ； Watson's caring theory

臺大護理雜誌

17卷1期（2021 / 01 / 01）

101 - 113

繁體中文

本文旨在探討一位薦椎脊索瘤侵犯，導致行走與排泄功能受損而進行腫瘤切除的個案照護經驗。照護期間為2019年7月8日至7月19日，個案面對罕見疾病治療與預後的不確定感及焦慮不安，運用Gordon 11項健康功能評估模式，透過直接照護、觀察、會談、傾聽、身體評估等方法來收集並歸納資料，確立個案較急迫的健康問題有：急性疼痛、便祕、身體活動功能障礙及焦慮，並運用Watson關懷理論於護理措施規劃，與個案、案妻建立良好關係，並促進個案舒適與身體活動功能，協助進行下肢肌力運動及大小便訓練；給予個案正面肯定，鼓勵其描述內心的想法及感受，協助其面對現實中的不確定感與焦慮情緒；增加對此罕見疾病的認知，使正處於壯年期且肩負重擔的個案，能重建自信心，更有勇氣與希望去適應新的生活。面對罕見疾病病人，除了建立其正確的疾病認知及照護外，予以更多的人性關懷、支持與陪伴，實能給病人帶來更大的幫助；盼藉此護理經驗，提供護理同仁照護罕病病人之參考。

The main purpose of this article was to explore the care experience of a patient who underwent tumor resection for a sacral chordoma that impaired walking and excretion functions. From July 8 to July 19, 2019, we used the Gordon 11 functional health assessment guide to assess patient by direct care, observing, consulting, listening, and performing physical assessment of the patient. The patient was found to have acute pain, constipation, impaired physical mobility, and anxiety health problems. Watson's caring theory was used in nursing care planning. This theory included providing positive encouragement to the patient, assisting the patient in facing uncertainty and anxiety, increasing his awareness of this rare disease, and allowing him to adapt to his new life. In the face of rare diseases, in addition to establish correct disease awareness, providing additional caring, support and accompany can afford greater assistance. It is hoped that this nursing experience will provide reference for nursing colleagues to care for patients with rare diseases in the future.