運用Watson關懷理論於一位血液透析患者憂鬱狀態之護理經驗

Nursing Experience with Using Watson's Caring Theory on Hemodialysis Patient with Depression

本文旨在探討運用Watson關懷理論照顧一位73歲血液透析患者憂鬱狀態之護理經驗。護理期間為2009年11月3日至12月5日，以觀察、會談、身體評估及查閱病歷收集資料，以五大層面評估，確立個案之主要護理問題有營養不均衡：少於身體需要、失眠、無望感等。個案因負向思考及無望感，出現自殺企圖，筆者先以真誠、關懷、接納的態度與之建立治療性人際關係，進而在護理過程中運用Watson關懷理論為基礎，同時運用生命回顧及增進支持系統功能，使個案能面對疾病衝擊，並克服身、心的不通，重新以正向態度面對血液透析治療，截至目前為止個案仍維持規律的血液透析治療。冀望由此護理經驗分享，提供照護理人員照護此類個案之參考。

This case report describes nursing experience with applying Watson's theory in caring for a 73-year-old hemodialysis patient with depression. The period of nursing care for this patient was from November 3, 2009 through to December 5, 2009. After primary diagnosis, data was collected through observation, interview, physical examination and review of medical records. The patients' condition was assessed in five dimensions and three nursing problems were identified: inadequate nutrition, insomnia and hopelessness. Suicidal tendencies due to the negative feelings of hopelessness were noted. The author began by approaching the patient with a sincere, compassionate and accepting attitude in order to establish a therapeutic relationship. Watson's theory was then applied when caring for this client. Life review, using a caring attitude and enhancing the support system enabled the client to face the impact of disease as well as overcome the physical and mental discomfort. The patient still undergoes regular hemodialysis therapy to this date. This case report hopefully provides a useful reference for nursing personnel caring for similar cases.