運用生命回顧於一位老人憂鬱症患者之照護經驗

An Experience Applying Life Review to a Geriatric Depression Patient

郭麗芳(Li-Fang Kuo) ； 王士華(Shih-Hua Wang)

《精神衛生護理雜誌》 8卷2期 (2014/01) Pp. 25-33

https://doi.org/10.6847/TJPMHN.201401_8(2).0004

摘要

本文描述一位老年憂鬱症患者因出現自殺危機而住院的照護經驗。護理期間自2009年8月11日至10月7日，筆者依五大層面評估確立—潛在危險性自我傷害、焦慮及家庭因應能力失調—為三項主要健康問題；護理過程除提供身體、心理社會及自殺預防照護，增加其安全與信任感，並協助採非自我傷害方式表達宣洩外，更運用生命回顧之治療模式於結構性會談，以其人生各階段為主題重新詮釋生命經驗，使個案能意識其情緒與過往生命經驗及所處情境的關係，進而降低焦慮及瞭解身體症狀，而後協助其統整接受生命經驗，以增加正向意義的探索及因應。個案於住院期間未再出現自殺行為；並經由家庭會談分享生命回顧所察，增進照顧者對個案情緒及表現的瞭解與因應能力。本文運用生命回顧的照護方式期望可提供護理人員在面對類似個案護理問題之照護參考。

關鍵字

生命回顧 ； 老人憂鬱症

並列摘要

This article describes the experience of caring a geriatric patient who has suffered from depression and been hospitalized for suicidal impulse. The nursing period started from August to October, in 2009. There were three main health problems found, including a risk of self-harm, highly-anxious emotion, and poor family coping strategies. After rendering physical, psychosocial and suicidal interventions to increase this aged female's feeling of safety and trust, we discovered alternative strategies to release emotional distress instead of harming behaviors. At the same time, we applied life review method involving a structured interview skill to evaluate her life. This interview aimed to re-interpret those negative experiences and conflicts in the past, and to newly provide with a positive meaning to life. It helps this case being aware of her depression and anxiety that could originated from the suffering, the physical symptoms and her life story. In the end of hospitalization, this individual case no longer thought about suicide, and because of this experience, we also enhanced our ability of understanding a patient's disease and psychodynamic in the nursing practice. This caring experience is valuable and implemental to future elderly care.

並列關鍵字

Life Review ； Geriatric Depression