運用行為修正方法增進一位思覺失調症患者的健康維護能力

A Patient with Schizophrenia Has Health-Maintenance Ability Enhanced by Applying the Method of Behavioral Modification

吳瑋庭(Wei-Ting Wu) ； 陳杏佳(Shing-Chia Chen)

《精神衛生護理雜誌》 9卷2期 (2015/04) Pp. 39-46

https://doi.org/10.6847/TJPMHN.201504_9(2).0005

摘要

本文目的在運用行為修正方法中的正向增強原則，協助一位思覺失調症病患增進其自我的健康維護能力。護理照顧期間從2011年3月22日至4月12日，使用身體、情緒、智能、社會及靈性五大層面評估，發現個案除了有思想過程紊亂、感覺與知覺紊亂的護理問題，因為精神症狀干擾、注意力缺乏和時間控管能力差，無興趣改善健康行為且無法負責維護個人基本健康，呈現無效性健康維護能力的護理問題。個案經藥物治療與團隊照顧後，思想過程紊亂、感覺與知覺紊亂的護理問題已獲得初步緩解，進一步藉由行為修正技巧，使用代幣制策略，與家屬和醫療團隊共同合作，以外出及口頭讚賞作為增強物，快速改善其無效性健康維護能力的問題。個案因此可主動執行正常作息項目和自我獨立負責維護基本健康。希冀提供此一成功經驗作為護理照護之參考。

關鍵字

思覺失調症 ； 行為修正 ； 行為約定 ； 健康維護能力

並列摘要

The purpose of this case report was meant to assist a patient with schizophrenia in enhancing her ability of health maintenance by applying the principle of positive reinforcement of behavior modification. Our care started from the 22th of March to the 12th of April, 2011. Through the assessment for physical, emotional, intellectual, social and spiritual dimensions, we found out that in addition to disturbed thinking process and disturbed perception, the case had ineffective health-maintenance ability problem. She had no interest in improving health behaviors, and couldn't be responsible for her basic health maintenance as the result of her interference of psychiatric syndrome, attention deficit and time mismanagement. After having adjusted the medication, the fore-mentioned disturbed thought and disturbed perception problems were relieved. By using behavior modification skills, the token strategy, cooperated with the case's family and medical team, walk-out and verbal recognition as the reinforcers, the problem of ineffective health-maintenance ability was quickly solved. The case later showed that she could take the initiative to perform well on a daily bases, deal with regular matters and demonstrated the ability of maintaining her basic health independently. We hope provide this successful experience of nursing care for reference.

並列關鍵字

Schizophrenia ； Behavioral Modification ； Behavioral Contract ； Health-Maintenance Ability

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