英文摘要 |
When critically ill patients are admitted to intensive care unit (ICU), it creates undoubtedly a physiological crisis for patients themselves and, meanwhile, causes mainly the psychological stress on family members. The ICU mortality is above 10% in general. Therefore, for family members, the stress of facing the situation that one of their family members is at the end of life in an ICU can be so tremendous that results inevitably in several complex stress responses as well as coping strategies. The above inspired the author for attempting to evaluate, by applying the Transactional Model of stress and coping, a main caregiver’s appraisal of stress and coping strategies when dealing with the stress caused by caring a patient who was at the end of life and to provide with appropriate care. During the period of caring an ICU patient at the end of life and her family members from October 5th to November 27th in 2007, the author observed the main caregiver’s responses and strategies in three aspects, including primary appraisal, secondary appraisal, and coping style as well as social resources. The study revealed two main problems that the main caregiver might face: (1) the inability of sense of control in dealing with worsening of the condition of the patient and (2) the feeling of loss when facing the patient near dying. During the caring period, by creating a sound relationship with the case, the author guided the case to express his inner stress by asking open-ended questions; moreover, with the assistance of the Family Support System, the author not only helped the case obtain relief from psychological stress and face the life changes but also assisted the case in weathering out the stress crisis. |