減重術後合併症個案面臨不確定感之護理經驗

An Experience Nursing an Uncertain Patient with Complications after Bariatric Surgery

本文描述一位接受腹腔鏡減重術後個案，數次入院接受術後合併症治療的護理照護經驗。於2010年6月至9月合併症住院治療期間，個案反覆感到無助、焦慮、悲傷，幾次住院後逐漸加深對預後的不確定感，最後甚至對治療失去信心。個案在第四次住院期間，筆者以Mishel不確定感理論為架構，確立個案有對預後不確定感的護理問題。於護理過程中，了解個案對預後不確定感的導因，藉由持續加強個案情緒支持、給予正向鼓勵、提供病況相關資訊、個別性的護理措施及建立醫病溝通管道後，提升了個案自我照顧能力及信心，增加其對疾病的控制感，並與家屬一同積極參與治療計畫，使個案度過合併症預後的不確定感受，順利返回社會家庭。

This article describes a nursing care case in which a 33-year-old housewife received laparoscopic bariatric surgery and developed complications requiring multiple subsequent hospital admissions. Throughout the course of treatment from June to September 2010, the patient repeatedly experienced anxiety, helplessness, and depression due to recurrent complications that resulted in her loss of confidence in the treatment provided by the surgical team. During her fourth hospitalization, the Mishel Uncertainty in Illness Theory (MUIT) was applied to assess and establish the cause of her feelings of uncertainty toward her illness. Through a combination of reinforced emotional support, encouragement, disease consultation, individualized care measures, and improved doctor-patient communication, the patient's ability to care for herself improved and she regained confidence in control of her own physical condition. In addition, the active involvement of the patient's family throughout the course of treatment enabled her to persevere through the uncertain treatment period and successfully return to a normal life.