運用薄井坦子全人照護模式照顧一位安胎孕婦之護理經驗

Nursing Experiences in Applying the Hiroko Usui Holistic Care Model to Look after a Tocolytic Pregnant Woman

本篇報告是描述一位33+3週因早發性子宮收縮接受住院安胎孕婦，面臨身心不適之護理經驗。護理期間為民國101年6月08日至101年6月26日，護理過程中筆者運用薄井坦子全人照護模式進行身、心、靈、社會之四大層面完整性評估，主動與個案建立良好的治療性人際關係，融入全人關懷，藉由觀察、會談、身體評估等方式收集資料並加以分析，確立個案主要護理問題有：潛在危險性損傷／早發性子宮收縮，焦慮／懷孕過程不順利、安胎結果，睡眠型態紊亂／身體不適、環境改變等三項護理問題。護理期間依個別性提供全人照護，增加住院期間的生心理層面舒適度，進而深入協助個案調適安胎所帶來的生心理影響，以改善焦慮及睡眠。建議於臨床照護安胎個案可運用薄井坦子全人照護模式來主動察覺個案需求，促進婦女在安胎過程的身心舒適。

This report describes the nursing experiences in a 33+3 weeks tocolytic pregnant woman who was hospitalized for spontaneous uterine contractions with physical and mental discomfort from June 8-26, 2012. The researcher applied the Hiroko Usui Holistic Care Model to proceed with integrity evaluation of physiology, psychology, spirit, and society, and actively established a favorable therapeutic interpersonal relationship with the patient, integrated concerns, and collected data through observation, interview, and physical evaluation for analyses. The case focussed on the nursing problems of risk of injury/spontaneous uterine contraction, anxiety/unstable pregnancy and tocolysis, sleep disorder/physical discomfort and environmental changes. Based on the personality, integrated care was provided in order to enhance the physiopsychological comfort in the nursing process. Through the assistance of the nurse, the patient overcame the physiopsychological impacts of tocolysis to relieve her anxiety and sleep. It is suggested that the Hiroko Usui Holistic Care Model could be applied to actively perceive the tocolytic case's demands, and enhance the physiopsychological comfort of women in the tocolysis process.