- 期刊
運用認知行為策略於雙相情緒障礙患者無效性因應能力之護理經驗
A Nursing Experience in Using Cognitive Behavioral Strategies to Enhance Ineffective Coping in Patients with Bipolar Disorder
摘要
本文為描述一位雙相情緒障礙症個案之照護經驗，筆者於2018年9月12日至2018年10月17日護理期間，藉由定期深度會談、傾聽、同理心及友善接納的態度與個案建立良好的治療性人際關係，並利用查閱病歷及五大層面進行整體性護理評估發現個案有：（1）無效性因應能力、（2）社交互動障礙等健康問題。筆者採個別性護理方式，並與個案討論後有意願嘗試改善自身健康護理問題，故利用認知行為策略，協助個案建立自我檢視及察覺之能力，進而引導因偏差認知所導致的後果及協助建立正向思考內容，並學習良好的溝通技巧及人際互動，利用「不良功能認知紀錄表」並加以記錄，結果呈現其因應能力能有效改善，人際關係之衝突減少且也重建自我價值及信心。期待藉由筆者照護經驗分享，提供臨床護理人員了解雙相情緒障礙症個案壓力因應的照護需求，進而改善其健康護理問題之臨床經驗參考。
並列摘要
This paper describes a nursing experiencing in caring for a patient with bipolar disorder. Between September 12 and October 17, 2018, the author conducted in-depth interviews with the patient on a regular basis, listened to his concerns, and adopted a sympathetic, friendly, and accepting attitude to establish a trustworthy therapeutic relationship. A review of the patient's health record and a comprehensive nursing assessment in five major areas revealed that several health problems were demonstrated, including (1) ineffective coping and (2) social interaction impairment. The author adopted an individualized care scheme and engaged in discussion with the patient, who then agreed to attempt to improve his health condition. Specifically, cognitive behavioral strategies was employed to help patient foster the ability to conduct self-reflection and self-awareness, which allowed him to review the consequences caused by cognitive bias, conduct positive thinking, and learn adequate communication skills for interpersonal interaction. A dysfunctional thought record was kept to highlight improvement in the patients' coping ability, who experienced less interpersonal conflicts and reaffirmed his self-worth and confidence. The nursing experience presented herein can serve as a reference for clinical nurses to understand the nursing needs of patients with bipolar disorder and improve the health conditions of such patients.