以家庭為中心重症病人家數的護理照護

Family-Centered Care for Families of Patients in Critically Ill Condition

加護病房是不對外開放的重症照護病房，接受加護病房治療的重症病人病情多屬危及生命的狀況，因此被限制在外的重症病人家屬會因為所愛的家人宣告病危感到沉重壓力，也因此有較為特殊的照護需要。但加護病房的醫護人員常忽略只在會客時間出現的家屬也是需要照護的，因此當家屬自己無法妥善處理壓力源，需求也未被滿足時，會逐漸累積成負面的情緒。而這負面的情緒不但會影響病人，讓病人心理不安；也會降低家屬協助病人做治療決策的能力，影響病人的權益。甚至容易造成家屬與醫護人員的衝突，讓醫病關係緊張。因此本文整理加護病房家屬的壓力源、需求以及對心理的影響，並且依據家屬的壓力源與需求，建議可提供的護理措施，讓在高壓環境工作的護理人員，能照顧好病人與家屬的身心，同時也讓病人家屬不再是護理人員的壓力源，達到三贏的局面。

Intensive care units (ICU) are designed for critically ill patients to receive intensive treatments and care for their life-threatening conditions, during which their families are not allowed to visit and stay with patients. The families of critically ill patients often feel heavily stressed when the loved one is announced to be in a critical condition; therefore, they have special care needs during this critical situation. However, ICU medical and nursing staff often ignore the families' care needs although they only appear during patient visiting hours. When families themselves are unable to properly handle their stress sources, and their care needs are not well taken care of, their stress will gradually progress into negative emotions. The negative emotions of families not only affect patients' psychological comfort but also lower the families' decision making ability for patients' treatments, affecting the patients' rights. Moreover, stressed emotions of family members easily cause mutual conflicts and create tense doctorpatient relationships. This article discusses ICU patient families' stressors and needs and their negative impacts on their psychological wellbeing. Some recommended family-centered care (FCC) measures can be applied to ICU patients and their families to meet their care needs for physical and psychological wellbeing. ICU nurses should be expected to take good care of their patients and families without seeing patients' families as a stress source, achieving a win -win situation among patients, families, and nursing staff.