運用跨理論模式協助一位更生人社會適應之護理經驗

A Nursing Experience of Applying Trans-theoretical Model to Help a Probationer Adapt to Society

余佳蓉(Chia-Jung Yu) ； 江青桂(Ching-Kuei Chiang)

《精神衛生護理雜誌》 10卷2期 (2015/12) Pp. 43-51

https://doi.org/10.6847/TJPMHN.201512_10(2).0005

摘要

本篇個案報告為運用跨理論模式協助一位更生人社會適應之護理經驗。照護期間自2011年6月16日到2012年12月31日，採用精神科五大層面整體性護理評估，藉由觀察、會談及參閱病歷收集資料，確認護理問題有無效性因應能力、長期性低自尊和家庭運作過程紊亂。筆者以跨理論模式為架構，評估個案在拒絕使用毒品過程之各個行為改變階段（準備期、行動期和維持期），提供自我效能、自我釋放、刺激控制、反制約、增強管理及協助關係之改變策略提升其社會適應能力。照護結果個案接受行為改變的歷程及自我肯定訓練，增強戒癮的動機並促發行動且不再碰觸毒品，其自信心也相對提升，在家人的鼓勵及支持下，順利於家屬自營的工廠就業。本個案照護經驗建議運用跨理論模式可以有效協助更生人社會適應，藉由個案動機的啟發及行為改變，提升家屬對個案的信心，進而獲得支持，促進家庭正向互動。

關鍵字

跨理論模式 ； 更生人 ； 社會適應

並列摘要

In this case report, we used the trans-theoretical model to help a probationer adapted himself to the social environment. The nursing care started from June 16, 2011 to December 31, 2012. We utilized the psychiatric five-dimensional global assessment to collect information from observation, patients' interview and chart review. We recognized the nursing care issues including ineffective coping skill, longterm low self-esteem, and family discord. We applied the trans-theoretical model to assess the patient's stage of change (preparation, action and maintenance) in resisting drug abuse process; several strategies were used to promote social adaptation, including self-efficacy, self-resolution, stimulation versus control, counter- refraining, and enforcement supervision and relationship’s improvement. The results show that the patient accepted behavioral change in procedure, underwent self-assurance's training, enhanced motivation and action of abstinence to reject illicit drug. The patient's self-esteem was promoted. Under the encouragement of family members, the patient worked at his family's self-employed factory. Our nursing care experience suggests that the trans-theoretical model could be used to help a probationer adapt to society through motivational enhancement and behavior change to increase the family member's confidence, support and positive family interaction.

並列關鍵字

trans-theoretical model ； probationer ； social adaptation

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