運用關懷理論於一位何杰金氏患者確診之手術全期照護經驗

An Experience of Perioperative Nursing Care Based on Watson's theory for a Patient Diagnosed with Hodgkin's Disease

本文主要是探討一位25歲年輕男性，因胸部斷層掃描發現右側縱膈腔腫瘤，疑似淋巴癌必須行胸腔鏡做腫瘤切片確診之手術全期照護經驗。筆者於2011年6月8日至2011年6月14日期間以手術全期護理概念並運用Watson關懷理論為基礎，藉由關懷、觀察、身體評估、術前及術後訪視、術中全程照護等技巧收集資料，歸納出健康問題有:焦慮、潛在危險性神經肌肉血管及皮膚完整性損傷、呼吸道清除功能障礙及不確定感。護理期間藉由傾聽、關懷、同理與個案及家屬建立良好護病關係，且提供手術相關訊息，並給予心理支持，減輕個案因為對手術過程不了解及擔心手術結果而產生的焦慮。並提供術後自我照護資訊，讓個案有信心面對手術，並能早日回歸正常生活。

The purpose of this paper aimed to investigate the perioperative nursing experience of a 25-year-old man with suspected mediastinal tumor diagnosed by chest CT scanner. Grounded on the concept of perioperative nursing care and Watson's theory, we examined the effect of tender care, observation, physical examination, pre-operative and post-operative visits, and intra-operative nursing care from the period 8 June 2014 to 14 June 2014. We gathered all patient data during this research time. The most essential problems could be summarized as follows: anxiety, potentially dangerous damage of neuromuscular blood vessels and skin integrity, airway clearance dysfunction, and uncertainty. During the caring period, we established good relationships between nurse, patient and the patient's family by caring, listening, and expressing sympathy. In addition, we provided not only sufficient messages about surgery-related information, but also physical support for the patient to realize the situation and eliminate side effects aroused by uncertainty, such as anxiety, and fear of surgical result. Finally, we provided useful information about post-operative care, and it reinforced the confidence of the patient and encouraged him to return to normal life as soon as possible.