運用Watson關懷理論照護一位愛滋更生人之護理經驗

Nursing Experience of Applying Watson's Theory to Caring a Probationer with Acquired Immunodeficiency Syndrome

本文描述照護一位愛滋更生人之護理經驗。照護期間從2019年9月13日至10月9日，病人出獄後回歸社會遭就業歧視，投靠經濟支持者哥哥卻因躁鬱症自殺，病人進而遭受親友閒言閒語，而自我放棄、飲酒作樂及生活作息不正常，導致急性胃出血入院，故引發筆者探討之動機。護理過程運用Watson關懷理論為基礎，以病人為中心，依照生理、心理、社會、發展及靈性層面進行整體性評估，確立有體液容積缺失、舒適障礙及心靈困擾等之護理問題。護理過程指導胃出血照護及飲食衛教，預防出血惡化；提供皮膚及神經痛之舒適照護，增進睡眠與休息；運用醫療團隊合作，建立支持系統，鼓勵表達負面情緒，並將書法喜好融入治療做為溝通媒介，舉辦「佛說人生藝術關懷活動」，以提升病人自信及成就感，使情緒困擾程度減輕為輕度。建議臨床護理人員照護愛滋更生人應從身、心、社會及靈性的觀點深耕，以病人為導向提供全人照護服務，藉此經驗分享照護此類病人之參考。

This article describes the nursing experience of caring an AIDS probationer. The nursing care period spanned from September 13 to October 9, 2019. Following release from prison, the patient experienced multiple psychosocial stressors, including employment discrimination, the suicide of a financial supporter with bipolar disorder, and stigmatizing gossip from relatives and friends. These factors contributed to alcohol abuse and subsequent acute gastric bleeding. A comprehensive nursing assessment was conducted based on Watson’s Theory of Human Caring, incorporating physical, psychological, social, developmental, and spiritual dimensions. Primary health problems identified included fluid volume deficit, impaired comfort, and mental distress. Individualized nursing interventions included education on gastric bleeding care and dietary management to prevent exacerbation, strategies to reduce skin injury and neuralgia, and measures to improve sleep and rest. The patient was encouraged to express negative emotions, and calligraphy, a personal hobby, was integrated into therapy to facilitate communication and self-expression. Additionally, participation in“Buddha Talks on Life and Art”activities aimed to enhance self-confidence and promote emotional well-being. Following implementation of these interventions, the patient demonstrated increased positive thinking and decreased negative emotions. This case highlights the importance of holistic, patient-centered nursing care for individuals living with AIDS, addressing physical, psychological, social, and spiritual needs. Integrating patients’personal interests and culturally sensitive interventions can enhance emotional resilience and overall quality of life. The experience may serve as a practical reference for nurses providing care to similar populations.