探討精神分裂症病患之情境家庭護理治療理念及其過程

Exploring the Theory and Process of Contextual Family Nursing Therapy for Schizophrenic Patients

黃瑞媛(Jui-Yuan Huang) ； 蕭淑貞(Shu-Jen Shiau)

《精神衛生護理雜誌》 7卷2期 (2012/12) Pp. 32-40

https://doi.org/10.6847/TJPMHN.201212_7(2).0005

摘要

本文目的為應用蕭氏「情境家庭護理治療」理念及過程照護一位社區精神分裂症個案及其家庭之護理經驗，以呈現理論與實務關聯之應用。筆者於2012年2月13日至2012年5月30日對個案提供居家護理治療以及電話訪視實務活動。照護期間以蕭氏情境家庭護理模式進行評估及問題分析，依據模式分析問題，發現如下：ww「結構性家庭特質」發現個案之家庭支持過度保護。（二）「家庭功能」發現個案及其家庭間有溝通、健康照顧和獨力依賴功能障礙。（三）「社會支持系統」發現個案及其家庭間有實質性與訊息性支持薄弱。照護者持續接觸個案及其家庭以情境家庭護理治療理念即生命的能量之能源、流動、根、目標，家庭護理治療過程之投入（engagement）、賦能（empowerment）、靈悟（enlightenmemt）等精神，發展社區個案及其家庭之照護行動。首先護理需融入、重視照護者與個案共同於家庭情境中體會覺察、分析個案及其家庭生命的能量，投入之家庭情境，激發情境中的家庭賦能，啟動家庭並認識情境問題，繼而啟發家庭解決問題的方法及策略，最終護理人員能協助促成個案及其家庭的靈悟，期望協助個案與家庭在社區中能參與社區活動，與發揮家庭的支持力量。本文以情境家庭護理理念進行家庭護理過程，探討居住於鄉村社區之精神分裂症個案及其家庭之經驗並提供應用實務參考。

關鍵字

情境家庭護理治療

並列摘要

This article aims to explore the Shaw's Contextual family nursing therapy and its process while taking care of a schizophrenic patient and his family to demonstrate the application of theory in correlation with practice. The author has provided a chronic schizophrenic patient with his family living in rural community with nursing care and paid visits through phone calls dated from February to May in 2012. During the period of applying Shiau's Contextual home care model, we have carried out evaluation and processed problematic analysis. According to the model of processing problems, we have the following finds of three aspects: 1. The aspect of structural characteristics of the family shows family support is over protected. 2. The aspect of family function shows dysfunction in communication, healthcare and dependence which affects the patient's psychiatric symptoms and stability. 3. The aspect of social support system displays weak support of substantial information. The caregiver has continued to contact the case and provide its family with hypothesis of Contextual family nursing therapy in which the family nursing process covers ”engagement, empowerment and enlightenment” to develop community individual case applying the home nursing activities. After all, nursing requires a great deal of efforts in care of individual cases and integrates the perception of family situations to analyze engagement, empowerment and enlightenment in each family. Furthermore, by activating the family's empowerment, nursing professionals can assist individual case and his family in facing situational family problems and suggest useful strategies including encouraging participation in community activities to strengthen family support. We believe this paper will provide a practical experience of using Contextual family nursing therapy to explore the nursing processes for schizophrenic cases and their families for practitioners' reference.

並列關鍵字

Shiau's Contextual Family Nursing therapy