運用團體懷舊治療減緩一位老年喪偶哀傷反應個案之護理經驗

Nursing Care Experience of Relieving an Elderly Widow's Grieg Reactions for Applying the Griup Reminiscence Therapy

本文說明護理人員照護一位面臨喪偶哀傷反應重度憂鬱症老人的護理經驗。於護理過程中運用紐曼系統模式給予整體性的評估，發現個案有高危險性暴力朝向自己、哀傷功能失常和無望感等主要健康問題。護理人員除了預防其自傷之危險性，並以接納和包容的態度，提供日常生活持續性的關懷與照顧，建立良好的護病關係；進而引導個案參加團體懷舊治療，激發療效因子和人際互動，讓個案有機會充分處理哀傷階段和自我統整，跳脫以往的自我封閉，於出院前已明顯朝向良好的自我統整狀態，重新展開健康的生活模式。

The purpose of this article was to illustrate the nursing experience in caring for an elderly widow with Major Depression due to heavy grief reactions. The author mainly used the Neuman's Theory to assess the patient during her hospitalization. The result indicated that patient's problems could be focused on the risk for self-directed violence, dysfunctional grief, and hopelessness. During the nursing process, the author tried to prevent the patient's risk from self-directed violence and adopted the techniques of acceptance, tolerance and continuous caring to establish solid therapeutic nurse-patient relationships. We also invited patients in group reminiscence therapy, to induce some therapeutic factors. It helped the patient ego integrity and her bereavement emotion management. After treatment and excellent care by the nursing staff, the patient had no self-absorption and succeeded in building up a healthy life style.