編輯的話：面對詭譎的疫情挑戰－發展精神衛生護理專業的新日常

Editorial Remarks: Development of Mental Health Nursing in Response to the New Normal and Unpredictable Challenges of the COVID-19 Pandemic

楊政議(Cheng-I Yang)

《精神衛生護理雜誌》 17卷2期 (2022/08) Pp. 2-4

https://doi.org/10.6847/TJPMHN.202208_17(2).01

摘要

自從2019年底開始至今，全世界的原有秩序都被COVID-19打亂，我們雖然都很希望疫情能夠趕快結束，讓一切恢復到疫情前的日常。但很遺憾的是，這時間沒有人說得準，且疫情的影響之劇與詭譎多變，到目前為止我們始終很難忽略它的存在。隨著疫情變化，我們大家在精神衛生護理的專業展現，包含相關政策的擬定、行政管理模式、臨床照護方式與專業學習成長等，都需要隨之而調整。我們已經經歷了一段很長的時間，習慣將「不確定性」當成是唯一可以確定的日常，非常考驗大家的應變能力，所幸大家在過程中都調適得非常好，不管疫情再怎麼侵擾，大致都能維持正常運作。從正向思考，一位專業的精神衛生護理人員，不能習慣性於一成不變，而是要勇於接受挑戰，因應環境變化、調整自己的作法，做出最好判斷，以提供給病人和家屬最好的照護。從這個角度來看，因應COVID-19對我們來說，可能可以是一個很好的試驗與成長經驗。本期總共收錄了一篇專欄稿、兩篇研究稿、一篇行政專案以及一篇的個案報告。首先，關懷（caring）的概念在護理專業中的重要性早已無庸置疑，說它是護理的核心、護理人員賴以生存和呼吸的東西也不為過，因為有它，讓護理人員對病人表現出專業照護與同理心，病人得以復原的更快速、康復的過程中獲得更好的照護品質。在我們本期專欄「關懷的心理衛生護理」一文中，蔡欣玲教授就強調了如何將護理關懷的概念，化為專業行動的展現，並舉例說明我們可以在多元面向的架構下，透過許多不同的方式進行與落實護理關懷。本期研究稿部分，分別收錄了一篇量性研究與一篇質性研究，陳建達等人（2022）在其「大學生時型及社會時差對躁鬱風險之影響」的研究中，發現大學生時型愈晚，其社會時差愈大，而社會時差及睡眠情形與其躁鬱風險相關，藉此提醒大學生宜建立穩定的睡眠週期及生活節奏，避免影響身心健康。另一篇「居家護理師照護輕度及中度失智症患者之行動意義經驗」研究中，陳怡樺等人（2022）陳述了居家護理師在照護居家的輕、中度失智症病患時，其所提供四個主要照護行動意義。此外，本期所收錄的行政專案，「降低精神科急性病房病人非自願性約束發生率」中，作者（陳淑瓊等，2022）分享了如何運用海報製作、相關教育訓練以及教學影片，成功改善了該精神科病房多年以來非自願性約束發生率偏高的問題，專案成效也包含提升護理人員認知正確率以及勸撫技術之正確率。而在「運用行為治療於自閉症個案自殘行為之照護經驗」的護理個案報告中，作者（呂保慶等，2022）則分享其經驗，描述如何運用行為治療以及個別化照護方式，照顧一位自閉症合併發展遲緩個案，因溝通及表達能力障礙、缺乏合宜之問題解決能力及情緒調適技巧，導致常出現以自殘來宣洩情緒知不恰當行為。個案健康問題複雜，作者利用護理期間，經由醫療團隊與個案、家屬結盟達到治療共識，並藉由行為治療來訓練個案學習合宜的情緒表達與調適技巧，成功減少其自殘行為。上述幾篇文章都非常值得參考。最後，感謝所有在各個角落守護全民健康的醫護人員們。面對COVID-19詭譎的疫情挑戰，我們仍深具信心，能繼續地不斷從失衡的生活與專業日常中站穩腳步，展現護理人員堅韌的專業性格，發展精神衛生護理專業的新日常。

並列摘要

Since 2019, the existing world order has been disrupted by COVID-19. People have hoped for the pandemic to end and return to normal life as soon as possible. However, so far the end of the pandemic remains unknown, and its unpredictable impact cannot be ignored. In response to changes amid the pandemic, adjustments must be made to the various aspects of mental health nursing, including policy formulation, administrative management, clinical care methods, and professional development. Uncertainty becomes the new normal and challenges people's resilience. Fortunately, nursing personnel in Taiwan have adapted to the situation favorably, with most of them being able to retain their normal daily routines in spite of the pandemic. Instead of adhering to their own habits, professional mental health nurses must face various challenge head on, adjust their methods in response to environmental changes, and make the optimal decisions to provide the most adequate care to patients and their families. With this context, COVID-19 may be an ideal test for sparking the professional growth of nurses. The current issue contains one special column, two research papers, one administrative project, and one case report. Caring is an indispensable constituent of nursing professions; it is considered the core value of nurses and lays the foundation of nursing practice. It enables nurses to demonstrate professionalism and empathy to patients, providing high-quality care and facilitating rapid patient recovery. In the special column "Caring in Mental Health Nursing," Prof. Tsai stresses the integration of caring into mental health professional nursing practice. Examples are provided on multifaceted frameworks for practicing care. This issue includes one quantitative study and one qualitative study. According to "The Effects of Undergraduates' Chronotypes and Social Jetlag on Their Risk of Depression and Hypomania" by C. T. Chen et al. (2022), college students with late sleep times exhibit greater social jet lag, and both chronotype and social jet lag are correlated with the risk of bipolar disorder. Therefore, college students are advised to form a stable sleep cycle and lifestyle to avoid negative physical and psychological health consequences. "Experiences and Meaning of the Action of Home Health Nurses Caring for Patients with Mild and Moderate Dementia" by Y. H. Chen et al. (2022) highlights the significance of four primary actions taken by a home nurse while providing care to patients with mild and moderate dementia at home. The administrative project, "Reducing the Incidence of Involuntary Restraint in an Acute Psychiatric Ward" by S. C. Chen et al. (2022), describes the use of posters, relevant training, and educational videos to successfully reduce the high frequency of involuntary restraining among patients in acute psychiatric wards. The researchers also improved the professionalism of nurses with regard to their nursing knowledge and ability to calm patients. "Nursing Care Experience of Using Behavioral Therapy to Reduce Self-Harm Behavior in Patients with Autistic Spectrum Disorder" by Lu et al. (2022) describes how behavioral therapy and personalized care were employed to care for a patient with autism and developmental delay. Because of impaired communication and expression skills and a lack of appropriate problem-solving and emotional adjustment skills, the patient frequently engaged in self-harm behavior to vent emotions. Because the patient exhibited complex health problems, the authors (2022) discuss jointly with the patient family and medical team to form a consensus on the treatment to be administered. Accordingly, behavioral therapy was used to train the emotional expression and adjustment skills of the patient. This in turn reduced the patient's self-harm behavior. The aforesaid articles are highly recommended to all readers. Finally, I would like to express my gratitude to all medical and healthcare professionals who have strived to protect public health. In the face of unpredictability associated with the COVID-19 pandemic, we should remain optimistic and gain a stable foothold while retaining everyday life and professional routines. Nurses will continue to demonstrate their resilient professionalism and adapt to the new normal of mental health nursing.