照顧一位慢性精神分裂症併有輕度智能不足患者的護理經驗

Nursing Experiences with a Patient Suffering from Chronic Schizophrenia and Mild Mental Retardation

王繼愛(Chi-Ai Wang)

《長庚護理》 11卷4期 (2000/12) Pp. 63-69

https://doi.org/10.6386/CGN.200012_11(4).0007

摘要

本文主要描述一位慢性精神分裂症併有輕度智能不足的患者，因疾病慢性化，呈現自我照顧缺失、言思貧乏，加上主要照顧者中風十餘年，對個案無法管教，導致在家或住院期間出現偷東西、隨意翻動病友物品、無法遵守病房吸煙規定等不適當行為，而家屬對疾病也不甚了解。筆者於民國87年3月19日至87年6月30日，以自我作為治療工具，傳遞真誠、接納、關懷，與個案建立信任的治療性人際關係，根據整體性護理評估，給予確立診斷後，運用行為修正技巧並反覆且耐心地用個案能瞭解的言詞教導，提升個案自我照顧能力，改善不適當行為並與家屬約談給予護理指導。結果顯示：個案藉著行為修正改善偷東西、隨意翻動病友物品等不適當行為，並經由護理指導而增加家屬對疾病的認知及治療的配合。

關鍵字

慢性精神分裂症 ； 輕度智能不足

並列摘要

In this article a patient with chronic schizophrenia and mild mental retardation is reviewed. As the patient's condition deteriorated poor personal care and poverty of thought were noted. The patient's main care giver had suffered a stroke some decades prior and was unable to influence the patient, resulting in disruptive behavior such as stealing, interfering with other patients' property, and not following ward regulations during the admission. The patient's family members were not familiar with the nature of the disorder. The author performed a therapeutic role between 1998.3.19 and 1998. 6.30 during the period of admission. The author used trust, receiving, caring, and giving to establish a trusting therapeutic personal relationship with the patient. Using total nursing evaluation, behavior modification skills were used after establishing the final diagnosis. By repeatedly instructing the patient with words that she was able to comprehend, there was a gradual improvement in self care skills and a decrease in the frequency of inappropriate behavior. The family learnt about the nature of the disorder and how to use behavior modification. The author reduced the inappropriate behavior, including stealing and intrufering with other patient's property, and was able to enhance the family's familiarity with the disorder and the patient's compliance with treatment.

並列關鍵字

chronic schizophrenia ； mild mental retardation