運用悲傷輔導原則照顧一位血液透析患者喪友之護理經驗

Nursing Experience with Applying Worden's Theory to Helping a Hemodialysis Patient Cope with Bereavement

本文為描述照顧一位血液透析患者渡過喪友悲傷期之護理經驗。護理期間98年5月23日至98年6月23日，筆者藉由會談技巧和行為觀察、記錄等進行資料蒐集，並運用Worden的「悲傷輔導原則」，再依身體、情緒、智能、社會、靈性等五大層面進行整體性護理評估。在評估後整理並分析，了解個案在喪失女友後產生個人身、心影響與衝突，確認個案具有睡眠型態紊亂、哀傷功能失常、無力感等三項護理問題。筆者在護理過程中利用傾聽、陪伴及同理心，給予個案支持及持續性照顧，透過護理措施，使個案能坦然面對女友去世的事實，並完成「哀悼的四個任務」，順利渡過悲傷期。在經歷悲傷痛苦後，能適應逝者不存在的新環境，並逐步走過悲傷的過程，回歸到正常生活，也讓個案成功的將情感轉移，並重新投注在未來的生活上。

The purpose of this article is to describe nursing experience with helping a hemodialysis patient cope with the grief of bereavement. The care period was from May 23 and June 23, 2009. Data was collected by the author through interviews, behavioral observations and records. The 'Grief Counseling Principles' from Worden's Theory was applied to physical, emotional, intellectual, social, spiritual dimensions to evaluate patient care. Identified nursing problems included: disturbed sleeping pattern, grieving dysfunction and powerlessness. During the nursing process, the author used listening, companionship and empathy to provide the patient with continuous care and help him come to terms with the death of his girlfriend. The 'Four Tasks of Grieving' were completed, enabling the patient to adapt to his new existence and focus on the future again.