運用Swanson關懷理論照護一位肺癌末期患者靈性困擾之護理經驗

Applying Swanson's Caring Theory to Manage Spiritual Distress in a Patient with Terminal Lung Cancer

本篇個案報告在於分享運用Swanson關懷理論，照護一位肺癌末期病患靈性層面之護理經驗。照護期間為2012年3月20日至4月25日，藉由觀察、筆談方式收集資料。依據Stoll提出之靈性模式，評估個體於靈性層面中與自己、他人、環境、神之間所產生靈性困擾之問題：（1）缺乏清楚堅定的人生意義、目的與希望，缺乏自我尊嚴；（2）無法感受他人所付出的關愛，不知如何表達對弟弟的謝意；（3）對神感到質疑與憤怒；（4）缺乏外在刺激與娛樂活動，居住於不熟悉、不喜愛之機構環境。照護期間筆者運用Swanson（1993）關懷理論中所提之了解（knowing）、在旁陪伴（being with）、為他做某些事（doing for）、使他能夠（enabling）與維持信念（maintaining belief）這五大過程，解決個案之靈性困擾並提供所需之靈性需求。期望透過此報告的分享，提昇護理人員對患者靈性需求的敏感度，提供有品質的靈性照護。

This case report shares a nursing experience that applied Swanson's Caring Theory as part of the care regimen for a terminal lung cancer patient suffering from spiritual distress. The nursing care was provided from March 20th to April 25th, 2012. Data were collected through observation and conversation and recorded using sketches and written notes. The nurse assessed the patient's relationships with the self, with others, with the environment, and with God in accordance with Stoll's spiritual interrelatedness hypothesis. Several spiritual distresses were reported. Interventions such as ＂knowing＂, ＂being with＂, ＂doing for＂, ＂enabling＂ and ＂maintaining belief＂ were applied to manage the patient's spiritual distress and address spiritual needs. This case report is intended to help increase the awareness and sensitivity of nurses to patients' spiritual needs and to help nurses provide effective spiritual care.