運用理論引導失智症家庭照顧者量裁式照護之經驗

The Nursing Experience of the Family Caregiver of a Dementia Patient- roviding Theory Guided Tailored Care

本文個案為一位失智症家庭照顧者，歷經5年之照顧過程，因失智症的婆婆疾病進程及家庭因素，致個案感到負荷而忽略自身健康狀況之護理經驗。護理期間自2013年6月15日至2014年5月20日。筆者以家庭照護壓力過程理論為依據，藉由原發性壓力源及續發性壓力源的評估，收集資料，經執行量裁式護理照護計畫後，家庭照顧者處理病人問題行為的知識與技巧增加，病人易怒的狀況也改善，主要照顧者負荷因而減緩；而家庭成員調整對家庭照顧者的期盼，家庭照顧者對於控制血壓自我照護之學習也比較積極，進而改善憂鬱情緒。此次經驗驗證以理論為基礎的失智症家庭照顧者量裁式護理照護計畫的初步成效，未來可供臨床照護之參考。

This case report describes the nursing experience of a family caregiver (FCG) of a dementia patient. The FCG suffered from burden and a lack of self-care as a result of the stress from having to taking care of a relative with advanced dementia. The individualized tailored nursing-care plan was based on a stress process model for family caregiving. It was implemented between June 15, 2013 and May 20, 2014. Data was collected by the assessing the primary and secondary stressors. After completing the individualized nursing care plan, the FCG was able to apply her increased knowledge and skills to manage behavioral problems of her patient, and the patient presented a reduced level of angry behavior. As a result, the level of burden on the FCG was lowered. In addition, other family members changed their opinion on the FCG. Consequently, the FCG felt motivated to manage her hypertension problems and gradually improved her depressive symptoms. We concluded that our individualized theory-guided nursing care plan had a preliminary positive effect on the FCG of the patient suffered from dementia. In the future, it could be applied in clinical practice as a service model.