運用Swanson關懷理論於一位粉塵爆炸創傷後燒傷病人心理社會調適之護理經驗

An nursing experience: use Swanson care theory in Psychosocial Adjustment for a burned patient with trauma after a dust explosion

本篇個案報告運用Swanson關懷照護理論：了解、在旁陪伴、為他做某些事、使他能夠、維持信念等五大照護過程，協助一位面對八仙樂園粉塵爆炸意外之創傷，所經歷急性嚴重燒傷心理社會調適之護理經驗。照護期間為2015年7月10日至9月5日，藉由定期會談、觀察及評估等方式收集資料，以整體性護理評估，確認個案有創傷後症候群、身體心像紊亂、無效性因應能力等健康問題。筆者與個案建立治療性及信任的護病關係，鼓勵個案表達內心感受，透過Swanson關懷照護理論促使個案接受身體因創傷後不一樣的自己，以及維持正向的信念來處理後續復健、學業及未來的規劃。期盼透過此次個案照護經驗，加強護理人員對創傷後急性燒傷病人之心理社會需求的敏感度，提昇病人心理照護的品質。

This case report has been using Swanson Care Theory: understanding, being with, doing for, enabling, and maintaining belief, as the five caring processes to help a patient from the Formosa Fun Coast explosion facing the acutely severe burns and establishing psychosocial adjustment. From July 10 to September 5, 2015, with regular meetings, observation, and assessment, we collected the data for holistic nursing assessment and then verified that there were some health problems, including post-traumatic syndrome, disturbed body image, and ineffective coping for the case. The author established a therapeutic and trusted nurse-patient relationship with the case, and encouraged the case to express her feelings. Through Swanson’s caring theory, we encouraged the case to accept her different body after the trauma, and keep a positive belief for rehabilitation, going to school, and future planning. We hope to strengthen nurses’ sensitivity for psychosocial needs of acutely burned patients in post-traumatic stage, and improve the quality of psychological care for patients.