運用關懷理論於一位青少年反覆性自殺之急診護理經驗

A Nursing Experience of an Adolescent Patient with Repeated Suicide Attempts Using Watson’s Theory of Caring

本篇報告乃運用關懷理論照護於一位青少年反覆性自殺之急診護理經驗，護理期間為2014年1月28日至2014年1月29日。照護期間筆者藉由觀察、會談技巧等方式收集資料，依個案生理、心理、社會及靈性四層進行整體性評估，發現家庭失和對個案有很大心理衝擊，加上唯一傾訴對象(父親)是家中經濟支柱需長時間工作無法陪伴，總覺得自殺可以解決一切。綜合評估結果顯示個案有高危險性暴力行為、個人因應能力失調、無望感主要健康問題。筆者運用Watson關懷理論為照護依據，與個案建立良好信任關係，教導個案如何宣洩負向情緒，進而改善負向情緒壓力時，以避免自殺事件再發生。建議在急診成立自殺個案管理，提供完整連續照護，以幫助遊走在自殺邊緣的個案。

This article reported a nursing experience of an adolescent patient with a history ofrepeated suicide attempts using Watson’s theory of caring. During the nursing period lastedfrom Jan. 28th to 29th, 2014, data were collected via observation and interviews for a holisticassessment based on the physiological, psychological, social, and spiritual aspects of thepatient. The patient was found to suffer psychological trauma from family estrangement,and with the sole confidant (father) the economic provider of the family who was mostlyabsent due to work, the patient came to a conclusion that suicide can resolve his misery. Theresult of a comprehensive evaluation had identified the following health issues: high risk ofviolence, coping deficit, and hopelessness. To prevent further suicidal attempts, the author,operated based on Watson’s theory of care, established a positive rapport with the patient,and taught the patient on the release of negative emotions and the coping strategies foremotional stress. The founding of a suicide case management in an emergency room, capableof providing a comprehensive and continuous care, is highly recommended. It ensures thatpatients on the verge of suicide could receive proper care and treatment.