運用不確定感理論於一位初次心肌梗塞病人的護理經驗

The Nursing Experience for a Patient with Acute Myocardial Infarction by Applying Uncertainty Theory

本文是描述一位初次心肌梗塞病人之照護經驗。期間為2012年12月26日至12月29日，於加護單位內藉由觀察、會談、身體評估檢查等方式收集資料，筆者運用Mishel不確定感理論為架構，進行主客觀資料之評估與分析，確立個案健康問題為不確定感與所處的環境及治療覺得複雜、缺乏疾病狀態與嚴重性及照護之相關訊息、無法預測疾病預後及擔心復發之處理有關。護理過程中提供安全的治療環境，建立治療性人際關係，鼓勵說出內心感受和不確定感來源，更主動以專業知識討論病況並提供疾病照護相關訊息，規劃個別性出院衛教，提昇其自信心，平安渡過急性期及緩解心中不確定感。藉此照護經驗分享，能提供護理人員在臨床照顧此類病人之參考。

The purpose of this article was to describe the nursing experience for a patient with acute myocardial infarction (MI) in an Intensive Care Unit between 26 and 29 December 2012. The data was collected by observation, interview, physical assessment and chart review. Mishel’s Uncertainty Theory was used to assess and analyze the subjective and objective data. The identified nursing problems were the uncertainty for the complexity environment and MI treatment, the uncertainty for insufficiency concerning information of MI symptom, progress of disease and care, as well as the uncertainty for MI prognosis and recurrence. During the process of nursing care, a supportive environment was provided to encourage the patient to express his uncertainty and feelings, and listen attentively. We provided MI information related to the disease care, and plans after discharge were provided specifically for the patient to reduce uncertainty levels. The patient successfully survived the acute stage and was relieved of uncertainty. The author looks forward to sharing this nursing care experience with other nurses who are going to take care of similarly affected patients.