- 期刊
認知行為治療應用於一位妄想症病患之護理經驗
A Nursing Experience of Applying Cognitive-Behavioral Therapy to a Delusional Disorder Patient
摘要
本文探討一位關係妄想個案，接受認知行為治療後之成效。文獻查證已知認知行為治療可應用於各類精神疾患，並可減少病患之妄想，幻聽的頻率，及改善情緒障礙、負性症狀及社交功能(Garety et al., 1997; Sensky et al., 2000; Turkington, 2006)。目前鮮少有護理措施合併認知行為治療運用於妄想症個案，引發研究者思考嘗試，使用此種護理經驗，期望對妄想症病患的照護有所幫助。在此個案護理過程中，研究者藉由觀察、會談等方式收集主、客觀資料，並運用整體性護理評估，發現個案有思考過程變異、社交功能障礙，以及自我概念紊亂等護理問題。護理期間為2007年7月2日至同年9月30日，護理人員以真誠的態度與個案建立治療性人際關係，運用家庭聯絡簿合併每週三次，每次五十分鐘，連續八次的認知行為治療於護理措施中，協助個案瞭解及確立其妄想性思考對其人際關係的負面影響，及合併出現的負面情緒與非理性想法，最後藉由認知行為控制技巧的教導與演練，修正其妄想性思考內容，進而改善個案人際關係，以及促進其社會適應。
並列摘要
This study examined the effect of Cognitive-Behavioral Therapy (CBT) on a patient with delusional disorder throughout the nursing process. There is strong evidence supporting the implementation of CBT for people with psychosis to reduce positive symptoms such as delusion, auditory hallucination, emotional problems and negative symptoms such as social dysfunction (Garety et al., 1997; Sensky et al., 2000; Turkington, 2006). However, the sparse literature in this field revealed the lack of application of CBT within nursing care for people with delusional disorder, indicating the necessity of this research for the potential benefit of people from similar contexts.The nurse gathered both subjective and objective data through interview and observation, and identified three majors nursing problems: altered thought processes、social functional disturbance and self-concept disturbance. From July 2 to September 30, 2007, the nurse had established a sincere, therapeutic relationship with the patient through psychiatric nursing care, including daily family-nurse communication diary and CBT sessions three times a week (8 times in total). This helped the patient reduce his irrational and negative beliefs, and improve his coping mechanisms. As a result, the patient improved his interpersonal relationships and adjusted his social behaviors.
延伸閱讀
- 馮欣蓓、許禎娟、曾雯琦（2006）。一位身體妄想型妄想症患者之護理經驗。源遠護理，1(1)，80-88。https://doi.org/10.6530/YYN.2006.1(1).10
- 蔡麗鈴（2009）。運用認知治療於復健期精神分裂症個案之護理經驗。志為護理-慈濟護理雜誌，8(1)，121-128。https://doi.org/10.6974/TCNJ.200902.0121
- 謝碧玲、張雅惠、李培壅、顏正芳、張明永、黃俊仁（2009）。妄想型精神分裂症病患之認知治療教育團體：學習成效之評估。高雄行為科學學刊，1(1)，40-48。https://doi.org/10.29854/TJKBS.200901.0003
- 林雅萍、侯淑英、余靜雲（2009）。運用認知行為治療改善一位精神分裂病患強迫症狀之護理經驗。高雄護理雜誌，26(1)，53-64。https://doi.org/10.6692/KJN-2009-26-1-5
- 呂銀芳、王銘輝、蘇碧玉（2023）。A Nursing Experience of Applying Cognitive Therapy to a Patient with Persistent Depressive Disorder。源遠護理，17(1)，35-43。https://doi.org/10.6530/YYN.202303_17(1).0005