運用Watson關懷理論於一位多發性硬化症病人首次接受雙重過濾血漿分離術之照護經驗

A Nursing Experience of Applying Watson's Caring Theory for Multiple Sclerosis Faced with the First Incidence of Double Filtration Plasmapheresis

本文運用Watson關懷理論協助一位多發性硬化症復發之女性病人，首次接受血漿置換術時發生輸血過敏反應後，改採用雙重過濾血漿分離術治療之照護經驗。照護期間自2007年11月24日至2007年12月08日，護理過程中以關懷照護的精神為指引，經身體評估、觀察、會談等技巧收集資料，確立健康問題有：焦慮感、家庭運作過程改變、預期性哀傷及潛在性感染等。透過護理活動的介入，建立良好互信關係與支持系統，減輕其內心的焦慮感，強化對疾病認識，坦然面對疾病的發展，提供持續性與整體性關懷照護，以緩和個案所面臨身、心、社會之壓力。此個案為本院多發性硬化症病人接受雙重過濾血漿分離術之首例，期望本文可提供護理人員日後在關懷照顧此類病人之參考。

The authors present a case study of a nursing experience applying Watson's caring theory to a female patient Multiple Sclerosis disease faced with the first incidence of an allergic reaction to blood transfusion, followed by Double Filtration Plasmapheresis. Data were collected by physical assessment, observation and discussion from the 24(superscript th) of November to December 8, 2007. Major nursing problems included: (1) Anxiety (2) Altered family processes (3) Anticipatory grieving and (4) High risk of infected. The authors describe the details of the primary intervention effort using Watson's caring theory in accordance with the spirit of nursing as conducted by the Mutual Confidence Foundation, and providing individual protective nursing. This relieved the patient's stress caused by physical, mental, emotional, and social factors in a case of Multiple Sclerosis Disease faced with the first Incidence of Double Filtration Plasmapheresis in our hospital. The authors shared this experience as reference for nurses who will deal with similar clients.'