應用社區精神衛生護理能力於精神分裂症個案的持續性照護

Applying the Competence of Community Psychiatric Mental Health Nursing to Continuous Care for a Patient Suffering from Schizophrenia

張國祥(Kuo-Hsiang Chang) ； 劉玟宜(Wen-I Liu)

《精神衛生護理雜誌》 8卷2期 (2014/01) Pp. 43-50

https://doi.org/10.6847/TJPMHN.201401_8(2).0006

摘要

本文目的為實踐社區精神衛生護理人員的角色功能，描述以「社區精神衛生護理能力」應用於一位精神分裂症個案的持續性照護經驗，照護期間為2013年9月5日至2013年12月17日，約為期三個半月，主要採取電訪及家訪方式執行照護與追蹤成果，依據中華民國精神衛生護理學會所發展的社區精神衛生護理實務能力指標，運用其中「治療性人際關係」、「建構自我」、「自我管理」、「疾病管理」與「資源連結」等範疇，以賦能及各能力的行為指標作為照護的步驟及策略，評估社區個案整體及持續性照護需求，設定個案提升自我價值、持續接受藥物治療、能管理其疾病症狀與執行日常生活的自我管理，並連結社區資源建構支持系統等為照護目標，照護結果顯示個案能於社區中維持精神病況的穩定，透過有效自我管理而維持生活作息之規律，並能積極且持續地參與日間病房復健活動，個案與家屬亦了解社區可用資源，建議精神衛生護理人員能展現社區精神衛生能力及相關策略促進精神病患之社區生活適應。

關鍵字

精神分裂症 ； 社區精神衛生護理 ； 能力 ； 持續性照護

並列摘要

The aim of this paper is to perform the nurse's functions in the community psychiatric mental health nursing. We, thus, applied the essential competence of community psychiatric mental health nursing to the patient suffering from schizophrenia who needs continuous care. The period of nursing care has proceeded from September 5, 2013 to December 17, for nearly three and a half months. In the duration of nursing care, we carried out the necessary procedures, tracked and followed up the treatment's outcomes through telephone calls and home visits in person. According to the Psychiatric Nurses Association, the essential competence of community psychiatric mental health nursing was developed on purpose to understand the integrity and continuity of care needs. With which they consist are therapeutic nursepatient relationship, self construction, self-management, illness-management, and resource linkage competence so as able to promote the patient's self-value acquisition, continuous medical treatment, disease symptoms management, and daily care by himself. The policy of care procedure is empowered and strengthened in relation to the patient's act. That helps construct his links to community resources as well as other supporting systems. On the other hand, the care results has shown that the patient can not only maintain stability in the psychiatric condition in the community, but also through effective self-management of lifestyle regularity adapt himself actively and continuously in the day ward for rehabilitation activities. Finally, the patient and his families understand and appreciate the resources accessibility in the community, suggesting that mental health nurses should display the competence for community care and further perform the related strategies to prompt the patient's adaptation to community life.

並列關鍵字

Schizophrenia ； Community Psychiatric Mental Health Nursing ； Competence ； Continuous Care