一位雙相情緒障礙症個案育兒期間引發鬱期發作之護理經驗

Nursing care of a bipolar disorder client with depression episode due to parenting stress

吳采奕(Tsai-Yi Wu) ； 陳秀枝(Hsiu-Chih Chen) ； 柯貞如(Chen-Ju Ko)

《安泰醫護雜誌》 25卷2期 (2019/12) Pp. 33-46

摘要

本篇為一位雙相情緒障礙症個案，因產後育兒壓力引發憂鬱情緒之照護經驗。自2016年3月09日至4月22日，筆者藉由臨床觀察及會談收集資料，以身體、情緒、智能、社會與靈性五大層面進行評估，確立健康問題為：情緒調適障礙、睡眠型態紊亂及無效性健康維護能力等問題。住院期間護理人員與個案共同討論母職角色轉換、育兒與經濟壓力及對案夫期待。引導個案抒發情緒、提供政府育兒補助津貼訊息，鼓勵個案與案夫互相溝通後，個案可運用縣政府育兒津貼，請保母照顧小孩。經濟方面由先生負責工作穩定家庭收支，讓個案安心養病。此外，並根據個案工作需求，與醫療團隊討論藥物調整，維持睡眠品質。護理過程，不但協助個案改善母嬰互動，提升對自我母職角色的信心，其情緒穩定度更大幅改善，出院後並能規則服藥與返診治療。

關鍵字

雙相情緒障礙症 ； 育兒壓力

並列摘要

This paper indicated the nursing care experience of a bipolar disorder client with depressive episode due to parenting stress of her new born baby. During the nursing period from 9th March to 22nd April 2016, the author collected data by clinical observation, interviews and medical record reading. Nursing assessment in physical, emotional, intellectual, social and spiritual dimensions were conducted. Health problems were identified as following: impaired emotional adjustment, sleep pattern disturbance, and ineffective health-maintenance ability. While hospitalization, the author and the client discussed on the issues about the changes of parental roles, parenting pressure, and family economic pressure. Moreover, the author encouraged the client and her husband to discuss their expectations toward each other, guiding the client to expressing her emotions and providing government children care subsidies information. Finally, the client could recuperate from their illness and make use of the county government children care subsidies to hire the babysitter taking care of her children. On the one hand her husband took the working responsibility to stabilize the family incomes and expenditures on the economic front. Additionally, the author discussed with the medical team to help adjust the drugs so as to maintain sleep quality for the client. After discharge, the client was connected by telephone. It was revealed that the client could not only adopt gradual and incremental ways to increase the interaction with her children but also intensify her parental confidence with stable mood. Furthermore, the client could also take medication and visiting psychiatric OPD regularly.

並列關鍵字

bipolar disorder ； parenting stress