運用Watson關懷理論照顧一位學齡前期兒童經歷開心手術之護理經驗

Utilizing Watson's Caring Theory when Caring a Preschool Child Following Open Heart Surgery

兒童對於住院易產生焦慮，加上手術更會加重壓力，本文描述一位患有法洛氏四重症的學齡前兒童，經歷開心手術住加護病房之護理經驗，筆者於2014年10月3日至10月11日護理期間，透過查閱病歷、觀察、會談及應用Gordon十一項健康型態模式進行整體評估，確立健康照護問題包括“呼吸道清除功能失效、急性疼痛、潛在危險性感染、分離焦慮。針對其問題，筆者依據Watson關懷照護理論，運用治療性遊戲輔助溝通，採取正向積極、陪伴傾聽、提供醫療資訊、促進舒適等護理描施，改善個案因手術造成的生理不適，進而病情獲得改善。經由此護理經驗發現照護個案時需融入其內心世界，才能理解她的想法不同於大人看法。建議照護類似個案時需運用其所熟知的語言及非語言，拉進彼此間的距離，才能使其積極配合治療，期盼藉此照護經驗，作為照護相關案例之參照。

The period of hospitalization is an anxious time for children, and surgical procedures will further enhance their stress. This article describes a nursing experience of caring a preschool aged child with Tetralogy of Fallot who was hospital-ized in the PICU from October 3 to October 11 in 2014. The medical record observation, inter-view and Gordon's functional patterns were obtained. Conducted overall assessment identi-fied health care project including airway clear-ance failure, acute pain, potential risk of infec-tion and anxiety of separation. Focus on this problem, was also acquired, we adopted positive attitude, use therapeutic play as a mode of com-munication, information offering, accompany and effective listening, according to Watson's caring theory, to advance comfort caring measure, to improve his postoperative physical discom-fort, and then improve the condition of sickness. Through this nursing experience, we found that mental health care should be integrated into. Freatment catching on his idea is important because it is usually different from the views of his parents. We suggested to use voice and non-verbal communication. To narrow the gap between patients and health care workers, and hope the experience could help other medical staff could approach these patients more readily.