一位SLE引起肺栓塞患者所面臨的衝擊與因應行為

The Impact and Coping Behaviors of a SLE Patient with Lung Embolism

本研究目的在探討一位SLE引起肺栓塞患者在住院期間，所感受的衝擊及其因應策略。本研究採田野研究法，在實際護理個案的過程中運用觀察、會談、及身體評估等技巧收集資料。護理個案期間之言語與非言語的行為以回溯方式寫成行為過程護理記錄，再加以整理、歸納、分析而成。研究結果顯示個案在住院期間所感受的衝擊包括身體層面、心理層面、社會層面與日常生活層面（執行日常生活能力的改變）；而其採取的因應行為有認知的再評價、情緒取向的因應及問題取向的因應行為。而問題取向的因應行為有：1.轉移注意力2.配合醫療處置3.主動詢問、收集資料4.接受事實。護理期間，筆者與個案建立良好的治療性關係，並採同感性傾聽及提供其情緒宣洩的管道，深入瞭解其內心的衝擊與壓力。希冀藉由此篇文章與大家分享照護此類病人時，護理人員可提供疾病相關的生理活動衛教、個別性的照護計畫及心理上的支持，來提升護理人員在照護此類病人上的醫療品質。

We reported the impact and coping behaviors of a SLE patient with lung embolism during hospitalization. We used the process-recording method to organize, classify, and analyze the patient's verbal and non-verbal behaviors. The impact of this patient included physiological, psychological, societal, and in daily living activity aspect. Her coping behaviors included problem-focused coping, cognitive reappraisal, and emotion-focused coping. Problem-focused coping included transferring attention, adhering to medical care, seeking information, and accepting the reality. During the study period, we have established a therapeutic relationship with the patient, listened carefully to patient, provided emotional support, and understood deeply her intrinsic impact and stress. Our experiences provided an example for clinical nurses taking care of similar patients. A comprehensive health education program, personalized caring plan, and emotional supports would greatly improve the quality of nursing care, especially to patients with special needs.