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題名:運用Watson理論及跨團隊模式照護一位思覺失調症合併十二指腸癌末期之病人
書刊名:長庚護理
作者:李宜玟林秀玲謝秀芬
作者(外文):Lee, Yi-wenLin, Hsiu-lingHsieh, Hsiu-fen
出版日期:2019
卷期:30:2=106
頁次:頁263-279
主題關鍵詞:Watson理論跨團隊模式思覺失調症十二指腸癌末期Watson theoryInterdisciplinary cooperationSchizophreniaTerminal phase duodenal cancer
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
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  • 共同引用共同引用:49
  • 點閱點閱:6
本文主要為筆者運用Watson理論及跨團隊模式照護一位思覺失調症合併十二指腸癌末期病人之護理經驗。護理期間為2017年1月10日至2017年4月10日,藉由觀察、會談、身體評估及病歷回顧蒐集資料,以五大層面評估,發現其主要護理問題為慢性疼痛、營養不足、高危險性暴力行為:朝向他人。筆者藉由運用Watson理論,了解其拒絕治療之原因及其妄想內容之背後含意,取得病人信任後再協助提供其現實感及病識感,另外可藉由以病人為中心,從關懷的角度同理病人因身體疼痛及精神症狀相互影響而不想接受治療時,以鼓勵、傾聽及陪伴的方式,澄清其拒絕治療之原因,鼓勵病人以言語表達想法,減少使用暴力行為做為拒絕治療之方式。病人於住院期間,藉由使用藥卡合併圖片解釋的方式,接受止痛藥物的協助,疼痛指數由10分下降至3分;飲食部分透過與病人建立互信關係後,以跨團隊合作的方式,與病人討論飲食契約,以關懷及鼓勵的方式,了解病人需求並接受院內餐點及營養素補充,體重也可維持於59-60.5公斤間無持續下降情形;高危險性暴力部分,藉由護理師在執行任何治療前,與病人清楚解釋說明治療之目的,並教導其學習情緒管理之方法後,病人可連續兩週以上未再出現暴力行為。現今精神科合併內外科疾病之病人日益增加,希望藉由此份報告,能提供護理人員對思覺失調症合併十二指腸癌之相關照護知識,亦可做為臨床照護之參考。
This case study reported nursing experience of applying Watson Theory and Interdisciplinary Cooperation to a schizophrenia patient with end-stage duodenal cancer. The nursing care took place between 10th January and 27th April 2017. Five dimensions of psychiatric nursing evaluation were conducted using clinical observation, psychiatric interview, physical assessment and medical chart review. The main nursing diagnoses included Chronic pain, altered nutrition (less than body requirements), attempt to aggressive, altered thought processes and sensory/ perception alternation. The author review the reference and used Watson Theory to the patient, first to understand why patient refused the therapy, then after the relationship building and had trust to each other, provide sense of reality and to improve insight, accompanying patient calm and peace to the end stage. Applying Watson Theory enabled the patient (1) to accept used painkiller to reduce pain from score 10 to 3, (2) to keep the weight about 59 to 60.5kg and no loss, and (3) patient can tell about what does she think before any theropy, and finally reduced violance and agitation. Nowadays the patient with mental illness and physical disease are increasingly, and this report provided a better understanding of schizophrenia patient and end-stage duodenal cancer and might serve as a reference for nursing staff while taking care of patients with schizophrenia patient and end-stage duodenal cancer in the future.
期刊論文
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8.陳秉華、邱仲峯、范嵐欣、趙冉、吳森棋(20160700)。基督宗教靈性關懷者對臨終病人靈性照顧能力之質性研究。安寧療護,21(2),166-179。new window  延伸查詢new window
9.梁淑媛、丁熙安、李慧貞、盧玉嬴、高聖惠(20140600)。疼痛對癌症病人的情緒衝擊。健康科技期刊,2(1),20-37。  延伸查詢new window
10.黃惠美、郭素真、王靜慧、張議文、周幸生(20120600)。建立成人癌症病人疼痛非藥物處置之臨床照護指引。榮總護理,29(2),145-158。new window  延伸查詢new window
11.Green, B. N.、Johnson, C. D.(2015)。Interprofessional collaboration in research, education, and clinical practice: Working together for a better future。Journal of Chiropractic Education,29(1),1-10。  new window
12.Swift, M. C.、Stosberg, T.(2015)。Interprofessional simulation and education: Physical therapy, nursing, and theatre faculty work together to develop a standardized patient program。Nursing Education Perspectives,36(6),412-413。  new window
13.吳瑋庭、陳杏佳(20150400)。運用行為修正方法增進一位思覺失調症患者的健康維護能力。精神衛生護理雜誌,9(2),39-46。  延伸查詢new window
14.杜秀容、劉秀雯、趙珊(2015)。安寧療護之營養照護。北市醫學雜誌,12(S),173-179。  延伸查詢new window
15.林盈束、曾雯婷(20161100)。運用行為治療於一位思覺失調症患者的護理經驗。精神衛生護理雜誌,11(1),27-35。  延伸查詢new window
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17.梁惠茹(20150700)。照顧一位十二指腸癌末期病人之安寧居家護理經驗。安寧療護,20(2),166-176。new window  延伸查詢new window
18.許毓心、張揚琴、許玫琪(20161100)。運用認知行為治療改善思覺失調症個案其家庭暴力之護理經驗。精神衛生護理雜誌,11(1),45-53。  延伸查詢new window
19.張雅欣、董依真(20161000)。運用關懷及安寧療護理念於胃癌末期病人之護理經驗。澄清醫護管理雜誌,12(4),54-63。  延伸查詢new window
20.曾毓閔、林仲祺、詹淑惠(20171200)。運用Swanson關懷理論於一位癌末病人及主要照顧者之護理經驗。長庚護理,28(4)=100,654-664。new window  延伸查詢new window
21.蕭淑華、謝佩琪、蕭嘉琪(20171200)。照顧一位青壯年鼻咽癌末期病人之護理經驗。長庚護理,28(4)=100,686-697。new window  延伸查詢new window
22.蘇郁捷、酈欽菁(20150700)。運用Watson關懷理論照顧一位胃癌末期病人的護理經驗。馬偕護理雜誌,9(2),76-89。  延伸查詢new window
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29.Horn, M.、D'Hondt, F.、Gharib, A.、Gangloff, L.、Dumais, A.、Amad, A.、Pins, D.(2018)。Association between familiarity disorders and serious violence among inmates with schizophrenia。Schizophrenia research,193,447-448。  new window
30.Hamza, N.、Darwish, A.、O'reilly, D. A.、Denton, J.、Sheen, A. J.、Chang, D.、Ammori, B. J.(2015)。Perioperative enteral immunonutrition modulates systemic and mucosal immunity and the inflammatory response in patients with periampullary cancer scheduled for pancreaticoduodenectomy: a randomized clinical trial。Pancreas,44(1),41-52。  new window
31.陳曉琦、周汎澔(20100600)。Watson人性化關懷照護理論與Swanson關懷照護理論之比較。護理雜誌,57(3),86-92。new window  延伸查詢new window
圖書
1.Watson, Jean(1985)。Nursing: Human Science and Human Care: a Theory of Nursing。East Norwalk:Appleton-Century-Crofts。  new window
2.American Psychiatric Association(2013)。Diagnostic and statistical manual of mental disorders。Washington, DC:American Psychiatric Association。  new window
其他
1.行政院衛生福利部(2016)。中華民國103年癌症登記報告,http://www.hpa.gov.tw/Pages/ashx/File.ashx? FilePath= ~/File/Attach/7330/File_6792.pdf。  延伸查詢new window
2.World Health Organization(2010)。Interprofessional Collaborative Practice in Primary Health Care: Nursing and Midwifery Perspectives,http://www.who.int/hrh/resources/observer13/en/。  new window
圖書論文
1.王怡文、陳玉婷(2015)。思考障礙之護理。精神科護理概論--基本概念及臨床應用。台北市:華杏。  延伸查詢new window
 
 
 
 
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