運用Watson關懷理論照顧一位長期血液透析患者之護理經驗

Applying Watson's Caring Theory in Caring for a Long-Term Hemodialysis Patient: A Nursing Experience

本篇運用Watson關懷理論探討一位長期血液透析患者因疾病及透析治療影響病患身、心、靈健康之護理經驗。筆者自2011年8月26日至9月19日期間藉由觀察、會談、傾聽、身體評估、病歷查閱及理學檢查等方式收集資料，確認個案最主要之護理問題為：疲憊感、身體心像紊亂及無望感。於護理過程中以Watson十項關懷照護要素為基礎，利用治療性溝通技巧與個案建立信任感，提供臨床照護如：加強水分控制、貧血之護理指導等降低身體不適，達到減低疲憊感目標。並透過持續的關懷、陪伴、同理及接納等技巧，鼓勵其表達內心對疾病及自我看法的感受，適時給予鼓勵與支持，協助個案改善身體心像紊亂及渡過無望感危機，善用宗教力量使其有勇氣及能量面對疾病治療及回歸正常生活。期盼此護理報告有助於增加醫護人員對於疲憊感的認識與了解，進而提升對長期血液透析整體之照護品質。

This study applies Watson's theory of human caring to investigate the nursing experiences of caring for a patient who had undergone long-term hemodialysis and whose disease and dialysis treatment had resulted This can affect their physical, mental and spiritual health. Between August 26, 2011 and September 19, 2011, the author collected data from observations, conversations, listening skills, physical assessment, medical history, and physical examinations for analysis to confirm that the health problems in this case were fatigue, body image disturbance, and hopelessness. The author applied ten caring elements from Watson's theory to the nursing process, using therapeutic communication skills to establish feelings of trust with the patient. These reliable methods were used to reduce fatigue, as well as physical and psychological discomfort. Continued care, accompaniment, empathy, and acceptance were used to encourage the patient to express inner feelings. Religious belief was enhanced to endow the patient with courage and energy to embrace life and reduce hopelessness. The aim of this nursing report is to increase recognition and understanding among clinical staff of the chronic fatigue symptoms of long-term hemodialysis patients. Using concrete and effective nursing measures to resolve the problems regarding nursing care for patients can improve the overall quality of life of patients.