An Overview of Generalized Anxiety Disorder and Reflections on the Effective Nursing Care of Patients with This Disorder

廣泛性焦慮症新知與有效性護理照護反思

呂雀芬(Chueh-Fen Lu) ； 陳妙絹(Miau-Chuan Chen) ； 許世杰(Shih-Chieh Shu)

《精神衛生護理雜誌》 7卷1期 (2012/10) Pp. 1-10

https://doi.org/10.6847/TJPMHN.201210_7(1).0001

摘要

護理教育中對焦慮疾患的認識，一直是以一個綜合的概念被介紹或以一個涵括式的視框來理解，其中個別疾患的認識是相對模糊的。焦慮疾患中盛行率最高者是廣泛性焦慮症（GAD），因此值得對其有更清楚的認識，以便提供護理給這佔大多數個案的精神衛生需求。本文以廣泛性焦慮症為範疇，介紹其盛行率、花費、歷史背景、病因、症狀表現、求醫行為、治療及預後，也包含將於2012年出版的DSM-V對GAD疾病分類之觀點。本文旨在藉對新知的理解與討論，來思考如何可以是一個適切的護理措施。亦即，儘管藥物治療有長足進步，或是認知行為治療指出其效能具顯著差異，然而並非所有的人都能受益，GAD仍具有慢性化特性。且因其共病性的特質，護理師對焦慮症患者情緒表現，特別是憂鬱狀態，應具備敏感的覺察。然，更重要的是，護理本身對「焦慮」之價值觀為何或立場必須有所思辨。如當我們從病理的角度來看待焦慮，則引發了以減低或消除焦慮的類醫療價值觀之護理態度。以全人關懷為範疇的護理專業並不等同於醫學哲學。在醫學框架之外，精神衛生護理應尋找多元的角度來理解或論述焦慮，也是護理之獨特性，例如從文化，而使患者的賦能以及與病和諧共存有所可能。

關鍵字

廣泛性焦慮症 ； 護理處置 ； 反思

並列摘要

In Taiwan, students of psychiatric nursing are taught about anxiety disorders as a whole. Consequently, they have vague knowledge of nursing care of specific anxiety disorders.Generalized anxiety disorder (GAD) has the highest prevalence rate compared to other diseases. Thus, a better understanding of GAD is vital to providing efficient care to most anxiety patients. This article aims to advance the understanding of GAD, including epidemiology, cost, historical background, aetiology, characteristics, help seeking behaviours, treatments, and prognosis. Moreover, the latest revision of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V) provides a clearer view of GAD. Based on this knowledge, nurses can reflect on how more appropriate nursing interventions may be designed. Despite improved medications and claims of efficacy of cognitive behaviour therapies, GAD remains a chronic disease with co-morbidities. Therefore, nurses need to be alert to mood changes, especially in patients with depression. Led by traditional pathological viewpoint. nurses tend to treat anxiety as a negative emotional state and this needs to be reconsidered. If the nursing profession views the patient as a holistic being, it should seek a different view of anxiety, for example, place it in the context of Chinese culture. In this way, patient empowerment can facilitate management of GAD.

並列關鍵字

generalized anxiety disorder ； nursing ； reflection