應用認知行為治療於一位思覺失調症個案之護理經驗

Applying Cognitive Behavioral Therapy in Nursing Care for a Patients with Schizophrenia

楊雅珊(Ya-Shan Yang) ； 吳瑞燕(Jui-Yen Wu)

《若瑟醫護雜誌》 11卷1期 (2017/04) Pp. 127-139

摘要

本篇是運用認知行為治療改善思覺失調症個案受幻聽、妄想之精神症狀及行為問題之護理經驗，護理期間為2012 年4 月10 日至6 月12 日。筆者藉由治療性會談及護理觀察方式進行資料收集，過程以短暫、分次被動持續性之方式接觸個案，會談時專注傾聽、同理及友善接納的態度與個案建立治療性人際關係，引導個案察覺錯誤的認知與辨識妄想與事實之差異，運用認知行為治療相關概念及技巧協助個案轉換思考，學習以正向自動化思考面對問題，並提供適切的護理措施，教導發展出替代信念後鬆動個案對妄想內容之固著、增進對幻聽的干擾及自我因應與管理，讓個案感受到被支持與接納。期待此種護理經驗，對思覺失調症個案的照護有所幫助，進而維持疾病症狀穩定及人際關係改善及促進其心理健康。

關鍵字

思覺失調症 ； 認知行為治療 ； 幻聽 ； 妄想

並列摘要

We report a woman of schizophrenia with auditory hallucination and delusion who received cognitive behavioral therapy. The care period was from April 10 to June 12, 2012.We collected the patient’s clinical information by means of therapeutic interview and nursing care. We approached her for several times briefly, passively but continuously. During the period, we built up therapeutic alliance by attentive listening, receptive attitude and empathy. Cognitive behavioral therapy was applied in whole nursing course. We guided the patient to detect the difference between delusion and reality. We then help her understand the inaccuracy of deviated cognitive assumptions and learn new strategies for dealing with issues. She then could have substitute beliefs other than rigid delusion, maturer coping skills for auditory hallucinations, and feel supported and accepted. We expect that applying cognitive behavioral therapy in nursing care could benefit patients of schizophrenia. It could ameliorate psychotic symptoms, reform interpersonal communication and promote mental health.

並列關鍵字

Schizophrenia ； cognitive behavioral therapy ； auditory hallucination ； delusion

參考文獻

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