應用不確定感理論照顧一位初患心肌梗塞病人

Applying the Theory of Uncertainty to Care an Individual Recently Diagnosed with Myocardial Infarction

在疾病中感受到不確定感往往對病人心理適應過程有著重大地影響。本篇文章目的在於探索不確定感對心肌梗塞個案於住院期間的衝擊及其適應過程。藉由觀察、會談與運用不確定感量表為評估指引，來收集資料並進行分析，發現個案在冠狀動脈疾病加護中心出現三階段不確定感與因應行為，包括：一、對疾病與症狀的不確定感；二、對檢查與療效的不確定感；三、對預後與自我照顧的不確定感。筆者運用多方面護理措施，包括：情緒支持、經驗分享、實例觀摩與持續衛教等相關措施介入，而有效地降低及改善個案因罹患心肌梗塞之不確定感所帶來之影響，希望藉此經驗分享，以提供醫護人員在未來照顧心肌梗塞病患時之參考。

Uncertainty is a major component of the illness experienced and can dramatically affect psychological adaptation. The purpose of this article was to explore the adaptation and impact of uncertainty on individuals with acute myocardial infarction (AMI) during hospitalization. A businessman recently diagnosed with AMI was observed and interviewed by his primary nurse in the coronary care unit (CCU). His behavior at the CCU was analyzed in the frame of uncertainty theory. The behavior of facing uncertainty and the ways to cope with were addressed into three phases: the first phase: the uncertainty of the progress of disease and symptoms; the second phase: the uncertainty of technical examination and the effectiveness of its treatment; the third phase: the uncertainty of his prognosis and his self-care abilities. The author applied a lot of nursing interventions to help the patient cope with, including mental support, experience sharing, continuous teaching and demonstration about his selfcare. In this study, patient’s uncertainty was significantly lessened.