運用Swanson關懷理論於一位蜂窩性組織炎病人之護理經驗

Applying Swanson’s Theory of Caring to Manage a Patient With Cellulitis

本文運用Swanson關懷理論照護一位因蜂窩性組織炎導致肢體活動障礙、因病程變化導致焦慮病人之護理經驗。照護期間為2020年3月8日至2020年3月22日，經生理、心理、社會及靈性四大層面進行評估，確立病人存有現存性感染、身體活動功能障礙、焦慮之護理問題。透過Swanson關懷理論的五大關懷過程，與病人及家屬建立治療性關係後，了解病人的需求及擔憂的事情，運用傾聽、在旁陪伴給予情緒支持，並滿足其需求，鼓勵病人參與肌力訓練進而維持正向信念，並教導病人腹式呼吸、肌肉放鬆、按摩肩頸、轉移注意力等緩解焦慮、放鬆的方法，使病人能夠以正向態度去面對出院後的生活。期盼此病人照護經驗，能夠給予護理人員在照護因疾病而導致肢體活動障礙、焦慮病人之護理經驗參考及運用。

This case report describes a nursing care experience that applied Swanson’s Caring Theory to a patient who was suffering from the rapid progression of cellulitis, which had impaired physical mobility and induced anxiety. The associated health problems, including infection, impaired physical mobility, and anxiety, were affirmed after an integrated physical, psychological, social, and spiritual assessment was conducted during the nursing care period, which lasted between March 8th and March 22nd, 2020. After Applying Swanson’s Caring Theory through five caring processes, the therapeutic relationships with the patient and his family members were established and their concerns and care needs were well known. Emotional support was provided through listening and accompaniment. In addition, the patient was encouraged to participate in strength training to improve physical mobility and maintain a positive outlook. In line with this, diaphragmatic breathing, muscle relaxation, shoulder massage, and divided attention were used to reduce anxiety and to assist the patient to face life after discharge positively and optimistically. It is hoped that this case report provides medical staffs with a reference for providing care to patients suffering from cellulitis, physical impairment, and anxiety.