運用行為修正於中度智能障礙合併肥胖個案之護理經驗

本文為運用行為修正於一位中度智能障礙合併肥胖症個案之護理經驗。個案因藥物副作用，導致口慾上升，體重持續增加，加上疾病因素理解力及判斷力受限，無法有效處理日常生活技能及人際互動。自2021年4月20日至2022年3月31日，透過觀察、會談等技巧，並運用身體、情緒、智能、社會及靈性五大層面評估，確立個案主要健康問題為肥胖、社交互動障礙及自我照顧能力缺失。以真誠、接納及持續性關懷態度與個案建立治療性人際關係，使用個案能理解的言詞，並搭配圖卡、影片等輔助工具，透過行為修正改善個案的不良習慣，達到減重成效，並習得良好的生活習慣及社交互動能力。盼藉由此個案報告，能提供行為修正在智能障礙合併肥胖症患者成功減重的佐證資料。這將對未來護理實務提供重要參考，並有助於改善智能障礙患者的生活品質。

關鍵字

智能障礙；肥胖；行為修正

並列摘要

This article discusses the nursing experience of applying behavior modification to a case involving a moderate intellectual disability combined with obesity. Due to medication side effects, the individual experienced an increase in appetite, leading to continuous weight gain. Additionally, limited understanding and judgment due to disease factors hindered effective management of daily life skills and interpersonal interactions. From April 20, 2021, to March 31, 2022, through techniques such as observation and interviews, and utilizing a comprehensive assessment across the physical, emotional, intellectual, social, and spiritual dimensions, the identified issues in the case included obesity, social interaction difficulties, and a lack of self-care abilities. A therapeutic interpersonal relationship was established with the individual through a sincere, accepting, and ongoing caring attitude. Behavior modification was implemented using language that the individual could comprehend, along with supportive tools such as cards and videos, to address and improve the case's unhealthy habits. This approach led to successful weight reduction and the development of positive lifestyle habits and social interaction skills. It is hoped that this case report can provide supporting evidence for the successful weight reduction of individuals with intellectual disabilities and obesity through behavior modification. This contribution is crucial for future nursing practices, aiming to enhance the quality of life for individuals with intellectual disabilities.

並列關鍵字

intellectual disability ； obesity ； behavior modification

參考文獻

呂保慶、趙珮如、蘇意淳、劉建宏（2022）．運用行為治療於自閉症個案自殘行為之照護經驗．精神衛生護理雜誌，17（2），41-50。[Lu, P. C., Chao, P. R., Su, Y. C., Liu, C. H. (2022). Nursing Care Experience of Using Behavioral Therapy to Reduce Self-Harm Behavior in a Patient with Autistic Spectrum Disorder. The Journal of Psychiatric Mental Health Nursing, 17(2), 41-50.] https://doi.org/10.6847/TJPMHN.202208_17(2).06

陳柏恆、蘇千玲（2021）．照顧一位思覺失調症個案體重過重之護理經驗．高雄護理雜誌，38（1），133－145。[Chen, B. H. & Su, C. L. (2021). Nursing Experience of an Overweight Case with Schizophrenia. The Kaohsiung Journal of Nursing, 38(1), 133-145.] https://doi.org/10.6692/KJN.202104_38(1).0012

曾婉婷（2015）．影帶示範教學應用於中重度智能障礙學生清潔服務技能學習成效之研究（碩士論文）．中原大學。[Ceng, W. T. (2015). Effects of Video Modeling on Cleaning Service Skills of Students with Moderate/Severe Intellectual Disabilities (graduate thesis). Chung Yuan Christian University.] https://doi.org/10.6840/CYCU.2015.00212

楊士弘、李安瑜、蔡昱潔（2022）．運用行為治療於一位青少年思覺失調症合併強迫行為個案之護理經驗．彰化護理，29（1），111-125。[Yang, S. H., Lee, A. Y., Tsai, Y. C. (2022). Applying Behavioral Therapy in Nursing Care for a Adolescents Patients with Schizophrenia and Obsessive-Compulsive Symptoms. Changhua Nursing, 29(1), 111-125.] https://doi.org/10.6647/CN.202203_29(1).0012

Lin, L. P., Lai, W. J., Yao, C. H., Hsu, S. W., Huang, H. T., & Lin, J. D. (2020). Regular Physical Activity and Related Correlates among Institutionalized Adults with Intellectual Disabilities. Health Promotion & Health Education Journal, 3(2), 11-20. https://doi.org/10.29442/HPRP.202007_3(2).0002

主題瀏覽