運用Johnson行為系統理論於日間病房重鬱症病人之照護經驗

Apply Johnson Behavioral System Model in the Practice of Nursing Care for a Major Depressive Disorder Patient in the Day Care Hospital

王珮珩(Pei-Heng Wang)

《精神衛生護理雜誌》 4卷1期 (2009/06) Pp. 65-71

https://doi.org/10.6847/TJPMHN.200906_4(1).0008

摘要

本文乃筆者照顧一位治療遵從性不佳、人際關係退縮、低自信、問題因應能力差而至日間病房復健之重鬱症病人，從96年4月26日至96年12月31日護理期間依Johnson行為系統模式評估，發現主要健康問題為無效性健康維護能力、社交互動障礙、無效性因應能力等，藉著Johnson行為系統理論配合認知治療，首先加強個案改變的動機，進而提升病識感及治療遵從性，其次參與工作復健使社交技巧及職業生產力提升，最後透過同理支持、激勵、人際互動訓練等方式發展出有效的調適技巧，終能回歸社會工作。由此得知在照護重鬱症病人時，可運用Johnson行為系統理論於短時間內確認護理問題，提供有效性之照護模式且可獲得正面成效，故值得對此理論有興趣者再去做深入探究。

關鍵字

重鬱症 ； 認知治療 ； Johnson行為系統理論

並列摘要

This article is a record from writer's experience of nursing care for a major depressive disorder patient who did not comply with therapy, had social withdrawal problem, had low self-confident, lacked of ability for handling the problems and hence was in day care therapy hospital. Via the Johnson behavioral system model evaluation in the nursing care practice during 26(superscript th) April and 31(superscript st) December 2007, the findings of the patient's health problems include ineffective heath maintenance, impaired social interaction, ineffective coping and etc. By applying Johnson behavioral system model together with Cognitive therapy, the first step was to increase the patient's motivation of change, enhance the patient's awareness of depressive disorder and compliance with therapy. The second step was letting the patient participate in the work therapy in order to improve his social skills and vocational productivity. Finally, via empathy support, encouragement and trainings of personal relationship and interaction etc, to develop the patient's effective adjustment skills in order to return to the working field in the society. Hence, by applying Johnson behavioral system model to identify the nursing problems in a short period of time, it provides an effective and positive nursing care model for the major depressive disorder patients. Therefore, to whom is interested about this theory, it is worthwhile for a further study.

並列關鍵字

major depressive disorder ； cognitive therapy ； Johnson behavioral system model