運用Swanson關懷理論照護一位直腸癌末期病患及其照顧者之護理經驗

本文描述一位直腸癌末期病患與其照顧者之護理經驗。照護期間2020年11月4日至11月16日，採用四大層面進行護理評估，確立病患出現腹瀉、無望感及照顧者出現預期性哀傷等健康問題。筆者運用Swanson關懷理論，以實證方法改善病患的腹瀉，也與個案建立良好信任關係，運用同理心、傾聽與接納技巧，鼓勵病患表達內心感受，以回憶療法讓病患回顧生命，從中獲得人生的價值與自我肯定，降低其無望感；給予病患與照顧者心靈支持，協助及鼓勵照顧者滿足病患心願，並透過安寧團隊了解及同理他們的內心感受，使其敞開心懷，緩解照顧者預期性哀傷問題。最後，在病患瀕死之際，達到病患善終、照顧者善生之目標。期望透過此病患的護理經驗，提供護理同仁實務之參考。

This article details a nursing experience involving a terminal patient with rectal cancer and her caregivers, spanning from November 4th to November 16th, 2020. Employing four levels of nursing assessment, four issues were identified, including diarrhea, hopelessness, and anticipatory grief among caregivers. The nurse utilized the Swanson Caring Theory to establish a trusting relationship with the patient. Empirical methods were employed to address the patient's diarrhea, while empathetic listening and acceptance facilitated the expression of the patient's emotions. Reminiscence therapy was utilized to foster self-affirmation and alleviate feelings of hopelessness. Spiritual support was provided to both the patient and caregivers, while assistance and encouragement were offered to fulfill the patient's wishes. Collaborating with the hospice team, caregivers were encouraged to express and understand their emotions to alleviate anticipatory grief. Ultimately, the goals of ensuring a peaceful end for the patient and supporting the caregivers were achieved. This nursing experience serves as a practical reference for nursing colleagues, highlighting the importance of holistic care and effective communication in providing end-of-life support to patients and their caregivers.