Lee Pin-Chieh, Hsiao Meng-Ping, Chang Chia-Chi
BSN, RN, Department of Nursing, National Taiwan University Cancer Center, and Master Student, Graduate Institute of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan, ROC.
MSN, RN, Head Nurse, Department of Nursing, National Taiwan University Cancer Center, Taiwan, ROC.
Hu Li Za Zhi. 2021 Dec;68(6):99-104. doi: 10.6224/JN.202112_68(6).13.
A nursing experience applying Swansons caring theory in the care of a teenage patient who received Nuss procedure for his pectus excavatum is described in this article. After the operation, the patient suffered from postoperative pain, lack of knowledge, and body-image disturbance. These symptoms influenced the patients physical and mental health, and prompted the author to do an in-depth investigation and discussion of this case. The nursing period lasted from July 3rd to 10th, 2019. The author conducted a comprehensive nursing assessment using observation, interviews, listening, and telephone interviews. The major problems identified were acute pain, lack of knowledge, and body-image disturbance. During the nursing period, the author established a good therapeutic relationship with the patient. The author applied Swansons caring theory to understand the patients healthcare needs and provide appropriate care. The author discussed the treatment direction with the patient, applied cognitive-behavioral strategies to relieve pain, educated the patient on developing and implementing individualized rehabilitation plans to establish correct posture in daily activities, and helped the patient adapt to post-operative changes in appearance and maintain a positive attitude toward the future. The age gap between the author and the patient required that the author spend additional time communicating with the patient to encourage him to open up his mind. It is recommended that hospitals offer youth communication skills lessons for nurses to enhance their communication and care skills with people of different age groups. In sharing this nursing experience, we hope to provide medical staff with a reference for caring for adolescent patients with disease-related body-image disturbance.
本文描述了在护理一名因漏斗胸接受努斯手术的青少年患者时应用斯旺森关怀理论的护理经验。术后，患者遭受术后疼痛、知识缺乏和身体形象紊乱之苦。这些症状影响了患者的身心健康，并促使作者对该病例进行深入调查和讨论。护理期为2019年7月3日至10日。作者通过观察、访谈、倾听和电话访谈进行了全面的护理评估。确定的主要问题是急性疼痛、知识缺乏和身体形象紊乱。在护理期间，作者与患者建立了良好的治疗关系。作者应用斯旺森关怀理论来了解患者的医疗需求并提供适当的护理。作者与患者讨论了治疗方向，应用认知行为策略缓解疼痛，教育患者制定并实施个性化康复计划以在日常活动中建立正确姿势，并帮助患者适应术后外观变化并对未来保持积极态度。作者与患者之间的年龄差距要求作者花费额外的时间与患者沟通，鼓励他敞开心扉。建议医院为护士提供青少年沟通技巧课程，以提高他们与不同年龄组人群的沟通和护理技巧。在分享这一护理经验时，我们希望为医护人员护理患有与疾病相关身体形象紊乱的青少年患者提供参考。
