運用Watson理論於護理一位SARS患者克服死亡恐懼之經驗

Nursing Experience of Conquering the Fear of Death for a SARS Patient Using Watson’s Theory

嚴重急性呼吸道症候群(severe acute respiratory syndrome, SARS)於2003年重創台灣醫療體系，台灣醫護人員感染SARS死亡率是全球排名第一，已造成七位醫護人員死亡，醫療工作者是感染的高風險群。本篇個案報告係運用Watson人性化關懷照顧理論之十項關懷照護因素於一位面臨SARS死亡恐懼的患者。個案本身為南部某教學醫院的醫師，因參與SARS患者的急救過程而感染SARS，於隔離期間親眼目睹往生室人員抬棺的情景及獲知同學死訊，使個案直接感受死亡的威脅，造成其負向生命態度與情緒反應。筆者藉由整體性護理評估及醫療團隊討論的方式收集相關資料，護理過程中經由觀察個案行為與情緒改變，運用關懷照護技巧與個案建立起良好的護病關係，護理重點主要為舒緩個案恐懼的情緒，鼓勵與醫療團隊合作度過疾病的危險階段，強化其支持系統注入希望，克服SARS所帶來之死亡恐懼，進而康復出院順利返回醫療工作，SARS病患所產生的生理、心理及社會整體性問題是複雜且多變的，提昇SARS病患的臨床照顧建立一套照護模式是後SARS時期刻不容緩的首要工作，期望藉由此個案照護經驗分享，能推廣人性化關懷照護於臨床護理實務之應用，並促進急性感染病患的照護品質。

Severe acute respiratory syndrome (SARS) deeply attacked Taiwan medical system in 2003. The case-fatality rate among infected healthcare personnel in Taiwan was the highest in the world, with seven medical personnel die from the episode. The case report used ten-item Watson humanization theory to care for a frightened patient of SARS. The case himself was a doctor working in a teaching hospital located in Southern Taiwan. He participated in the first aid course of SARS patient and got infected. After witnessing the coffin lifting scene and knowing the death news of his classmate, the case experienced the threat of death. Through comprehensive nursing assessment and collection of relevant materials of group discussion, emotional nursing care was provided to relieve patient’s fear of death and encourage him to cooperate with medical team to get through the dangerous stage. The hysiological, psychological, and societal issues of SARS are complicated and variable. The primary task is to establish a standard SARS nursing care model to prepare for future impact of emerging infectious diseases. This article described the application of humanization care with the hope to improve the quality of caring for patients of acute infectious disease.