運用Swanson關懷理論於一位血管炎導致無力感老人之護理經驗

Applying Swanson's Theory of Caring to Manage Powerlessness in an Older Patient With Vasculitis

本文為描述運用Swanson關懷理論於一位因血管炎疾病無法行走及延後出院，而產生無力感老人之護理經驗。照護期間為2018年4月26日至2018年5月5日，經生理、心理、社會及靈性四大層面進行評估，確立個案存有身體活動功能障礙及現存性感染等生理問題，且延伸出無力感之護理問題。透過Swanson關懷理論中所提之了解、在旁陪伴、為他做某些事、使他能夠與維持信念的五大關懷核心，引導個案參與自我的治療計畫，增強其復健動機；並協助家屬提升照護的能力及信心，為返家做準備；另結合宗教的關懷，鼓勵個案情緒抒發，學習正向紓解方式，達到心靈的安適。同時從生理、心理及靈性層面著手，協助個案重新找回自己的價值，提升對於未來的正向信念。藉由此照護經驗，期盼給予護理人員在照護因疾病而導致無力感的老年病人參考及運用。 This case report describes a nursing care experience that applied Swanson's Caring Theory to a powerless elderly patient who was suffering from vasculitis problems that had made her incapable of walking and had delayed her discharge from the hospital. The associated health problems, including impaired physical mobility, infection, and powerlessness, were affirmed after an integrated physical, psychological, social, and spiritual assessment was conducted during the nursing care period, which lasted between April 26th and May 5th, 2018. The five categories (knowing, being with, doing for, enabling, maintaining belief) of Swanson's Caring Theory were applied. The patient was encouraged to participate in the treatment plan and motivated to participate in rehabilitation. In addition, the caring capacity and care confidence of family members was enhanced in order to support the patient’s further care after discharge. Furthermore, religious support was involved, which allowed the patient to communicate her emotions, reduce her stress, and achieve spiritual comfort. By providing care in the realms of physiology, psychology, and spirit, the author helped the patient regain her self-worth and enhance her positive beliefs in the future. This case report is hoped to provide medical staffs with a reference for facilitating the recovery of elderly patients experiencing disease-related powerlessness.