家庭復原力模式之臨床應用－－協助一位呼吸器依賴病患家庭調適之護理經驗

Resiliency Model Application: Caring for a Family with Ventilator-Dependent Client

本個案報告係運用McCubbin(1993)之家庭復原力模式(Family resiliency model)，協助家庭自調整不良(Mal-adjustment)之危機狀態進入適應階段(Bon-adaptation)之照護經驗。研究對象為南部某醫學中心一個因有長期使用呼吸器患者而瀕臨危機的家庭。應用家庭復原力模式評估此家庭，發現此家庭積聚的壓力持續減損家庭成員個人與整體的健康，原有的因應能力已不敷使用，正處於調適不良的危機當中，經歸納此家庭主要護理問題有三：主要照顧者身心疲潰、家庭成員溝通型態不良、以及家中稚子缺乏教導與學習對象。筆者將此家庭調適壓力過程之不足與需求，作為照護活動的施力點，設計合宜的護理措施，協助家庭成員反觀自我，確認、開發並應用家庭資源，促使家庭終能新增生活動力之護理經驗。期此照護經驗之分享，可拓展護理人員的家庭照護能力，提昇家庭照護品質。

The family case study demonstrated the application of family resiliency model in helping a ventilator-dependent patient’s family from mal-adjustment toward bon-adaptation. Using the family resiliency model to assess this family, the authors found the case was in the mal-adaptation (family crisis) status due to multiple stressors and ineffective coping strategies. This family presented three main health problems: caregiver role strain, impaired verbal communication between couples, and altered parenting role (children lacked of role modeling and supervision). The family members were guided to recognize the chaotic family situation and find their own strengths and available resources to solve their current problems. This case study report provides a useful example of family nursing care.