運用關懷理論照顧隔離個案面臨喪親之護理經驗

Nursing Experience of Using Caring Theory in Caring for an Patient in Isolation Facing Bereavement

本文描述運用關懷理論照顧一位新冠肺炎個案隔離期喪親心感愧疚之護理經驗，照護期間自2021年6月4日至6月15日。筆者運用生理、心理、社會及靈性層面架構評估，藉照護、觀察、會談及病歷查閱方式收集資料，確立個案具有低效性呼吸型態、焦慮及哀傷之健康問題。個案因確診後傳染給案父，導致父親因病程進展最後呼吸衰竭病逝，個案心感自責愧疚與強烈哀傷，因隔離治療，處理父親後事挑戰重重，引發心理問題。照護過程中，運用通訊軟體提供新型冠狀病毒肺炎相關資訊以緩解其焦慮。個案生理不適時，提供藥物及氧氣，教導舒適俯臥及呼吸訓練，解決低效性呼吸型態問題。協同心理及靈性團隊解決心理問題，藉手繪插圖及文字予鼓勵，提供院內禮儀公司資料圓滿案父後事，使個案降低哀傷感。建議往後臨床照護類似個案時，須重視其心理問題。此外，運用關懷理論概念，融合全人精神，予個別性資源，以陪伴個案渡過喪親過程。期許此次照護經驗可為未來照護類似個案之參考，提升臨床護理照護品質。

A nursing experience using caring theory to care for the grief experienced by a patient with COVID-19 during their period of isolation from June 4 to June 15, 2021 is described in this article. The patient was assessed using physical, psychological, social, and spiritual framework assessments. Data were collected using care, observation, interviews, and medical records. The healthcare problems were identified as inefficient breathing patterns, anxiety, and grief. The patient transmitted COVID-19 to her father, who subsequently died of related respiratory failure. During the nursing process, we used a mobile application (app) to provide the patient with information about novel coronavirus pneumonia to relieve her anxiety. When the patient was physically unwell, we delivered drugs and oxygen, and provided comfortable prone position and breathing training to resolve her low-efficiency breathing patterns. Also, we cooperated with the psychological and spiritual team to resolve the patient’s psychological problems, used hand-painted illustrations and words to provide encouragement, and provided information on the hospital’s funeral services provider to help complete her father’s funeral arrangements to reduce her sense of grief. It is suggested that, in the clinical care of similar patients, nurses should pay more attention to their psychological problems. In addition, nurses may use the concepts of caring theory to integrate a holistic approach, provide patient-specific resources, and accompanying the patient through the process of grief. This nursing experience may be used as a reference in the future care of similar patients to improve the quality of clinical nursing care.