運用Watson關懷理論於一位初次罹患神經母細胞瘤患者之護理經驗

Applying Watson’s Theory in a Nursing Experience for a Patient with Neuroblastoma

本文運用Watson關懷照護理論為基礎，護理一位初期發現症狀而診斷為神經母細胞瘤個案住院接受治療之經驗。護理期間為2009年12月15日至2010年1月10日，筆者藉由直接護理、觀察與會談的方式收集資料，針對個案身、心、社會與靈性各層面評估，發現有焦慮、口腔粘膜改變、身體心像紊亂等問題。在護理的過程中運用同理心，主動關懷、陪伴，與個案建立信任感並培養合宜的治療性人際關係及提供疾病相關資訊等技巧；針對上述護理問題，訂立合宜護理目標與照顧措施，藉由個案支持系統引導其表達內心感受，能坦然面對疾病所造成的衝擊，並設法維護適當營養與口腔衛生等，評值各方面則皆有正向結果呈現。此疾病為常見的惡性腦腫瘤，然國內近期缺少此類個案探討文獻，因此，期望此照護經驗分享能供日後照顧類似個案之參考。

The case report highlighted on Watson’s theory application to care for a patient with neuroblastoma hospitalized in the stage of initial diagnosis. The caring duration was from December 15, 2009 to January 10, 2010. Through the direct nursing care, observation and interview holistically to evaluate all the physical, psychosocial and spiritual dimensions of the client, we had identified that the patient was victimized the problems of anxiety, altered oral mucosa membrane, and body image disturbance. The Watson’s caring theory was applied under the guidance for care plan. The goals of the intervention were aimed to help the patient to express her feelings, adjust the impact of disease, and maintain appropriate nutrient status, good oral hygiene through the strategies such as empathy built-up, caring, accompanying, building up trust and good relationship with the patient, and to provide the information of medical care. Neuroblastoma is a common malignant disease. However, the references of this kind of care plan were rare. Thus, this case report sharing may provide health professionals with some references to care the similar patients.