照護一位憂鬱症青少女反覆性自殺之加護經驗

本文為探討一位罹患憂鬱症青少女服用過量安眠藥之加護護理經驗，筆者於2018/11/17-11/21照護期間，藉由實際觀察、會談、傾聽、身體評估、查閱電子病歷等方式蒐集資料，透過生理、心理、社會及靈性四方面進行評估，確立個案的健康問題包含：一、急性混亂／與服用過量安眠藥物有關；二、潛在危險性電解質不平衡／與服用安眠藥物副作用有關；三、危險性自我傷害／與課業壓力、人際關係與無效因應能力有關。照護期間針對服用過量安眠藥物，進行洗胃後給予適當的水分補充，減少有毒藥物吸收、促進藥物排出體外，並密切監測血清、電解質變化以穩定生命徵象，最後藉由會談過程了解其憂鬱情緒與引發自殺的心理，教導如何宣洩負向情緒，進而改善負向情緒壓力，並提供心理支持及社會資源介入協助，如生命線等，避免自殺事件再發生，不僅提供醫療處置亦能深入其心理層面之照護。筆者期望藉由護理經驗分享，反思並凸顯自殺個案生、心理照護的重要性，及提供相關兒科照護人員參考。

關鍵字

青少女；憂鬱症；自殺

並列摘要

This article discusses the intensive care experience of a depressed teenage girl who overdosed on sleeping pills. During caring period in November 17th to 21st, 2018, the author Collect data through actual observation, interviews, listening, physical assessment, and access to electronic medical records, and conduct assessments from four aspects. These aspects include physical, psychological, social, and spiritual. Hence establish the health issues of this case include: firstly acute confusion relating to overdose on sleeping pills, secondly the potentially dangerous electrolytes imbalanced relating to the side effects of overdosing sleeping drugs, and thirdly the dangerously self-harm behavior relating to academic stress, interpersonal relationship and ineffective coping ability. During the nursing period, for treating overdose of sleeping medications, appropriate water supplementation after gastric lavage to reduce the absorption of toxic drugs, promotes the excretion of drugs, and closely monitors changes in serum and electrolytes and stabilizes vital signs. Finally, through the interview process, in order to understand her depression and the psychological reason behind the suicide; teach how to release negative emotions, and hence adjust negative emotional pressure; provide psychological support and social resource such as lifeline to prevent the recurrence of suicides. Apart from providing medical treatment also intensify psychological care. The author hopes to review and emphasis the importance of suicide cases with physical and psychological care through sharing this nursing experience, and to provide a reference for relevant pediatric care personnel.

並列關鍵字

female adolescent ； depression ； attempted suicide

參考文獻

Yang, F. Y., Lai, C. Y., Yen, C. F., Hsu, Y. Y., & Zauszniewski, J. A. (2017). The depressive symptoms, resourcefulness, and self-harm behaviors of adolescents. The Journal of Nursing Research : JNR, 25(1), 41-49. https://doi.org/10.1097/jnr.0000000000000127

Chen, Y. L., Chen, W. J., Lin, K. C., Shen, L. J., & Gau, S. S. (2019). Prevalence of DSM-5 mental disorders in a nationally representative sample of children in Taiwan: Methodology and main findings. Epidemiology and psychiatric sciences, 29, e15. https://doi.org/10.1017/S2045796018000793

Domínguez-García, E., & Fernández-Berrocal, P. (2018). The association between emotional intelligence and suicidal behavior: A systematic review. Frontiers in Psychology, 9, 2380. https://doi.org/10.3389/fpsyg.2018.02380

Hards, E., Ellis, J., Fisk, J., & Reynolds, S. (2020). Negative view of the self and symptoms of depression in adolescents. Journal of affective disorders, 262, 143–148. https: //doi.org/10.1016/j.jad.2019.11.012

Holly, C., Porter, S., Echevarria, M., Dreker, M., & Ruzehaji, S. (2018). CE: Original research: Recognizing delirium in hospitalized children: A systematic review of the evidence on risk factors and characteristics. The American Journal of Nursing, 118(4), 24-36. https://doi.org/10.1097/01.NAJ.0000532069.55339.f9

主題瀏覽