- 期刊
協助一位女性思覺失調症個案調適婚姻壓力之護理經驗
Nursing Experience of Martial Stress Coping for a Female with Schizophrenia
摘要
婚姻對思覺失調症患者提供穩定的力量，然而，在婚姻中期待女性思覺失調個案操持家務、教養子女、照護生病長輩與婆媳衝突，也為個案帶來諸多壓力。本文描述一位38歲罹患思覺失調症女性，因婚姻適應與照顧公公的壓力，疾病復發住院之護理經驗。護理期間為2016年3月18日至4月18日。筆者藉由觀察及會談收集資料，進行個案身體、情緒、智能、社會與靈性五大層面評估，確立護理問題為：感覺知覺紊亂、思考過程紊亂、個人因應能力失調與照顧者角色緊張。護理過程鼓勵個案書寫日誌，釐清幻覺對生活的影響，發展因應幻覺的技巧；妄想方面，則協助調整生活重心，增加現實感；個人壓力調適方面，協助個案在個人、夫妻與親子互動及婆媳相處層面調適壓力；照顧者（案夫）壓力調適方面，則偕同醫師提供疾病衛教，鼓勵個案與案夫開放溝通，協同其他成員如婆婆與小叔一起來承擔家庭責任，緩解個案壓力。建議在女性思覺思調個案性別敏感度照護、男性照顧者壓力與學齡期兒童精神疾病衛教部份，需透過更多實證研究與實務經驗分享，方能為個案提供更整全的照護。
並列摘要
Marriage reveals as a stabilized power for female with schizophrenia. However, expectation toward schizophrenic female such as housekeeping, child education, taking care of elder and conflict with mother-in law represents stressful issues for the clients. This article described the experience of caring for a 38 years old female who suffered from Schizophrenia relapse. From 18th March till 18th April 2016, the author collected information through observation and interviewing to assess the client’s physical, emotional, intelligent, social and spiritual health. Nursing issues included disturbed sensory perception, disturbed thought process, ineffective coping, and caregiver role strain were identified. During the care period, the client was encouraged to write a diary to clarify the impact of hallucinations on her daily life, and to develop coping skills for hallucination based on her caring characteristics. Moreover, the author assisted the client to reintegrate her life purpose as a way to improve her sense of reality. In terms of stress adjustment, the client was helped to clarify her stress source and develop coping strategies. Finally, the client and her husband were encouraged to share their inner feelings and to find the positive power in their marriage. The caregiver strain suffered by the client's husband was addressed by working with the doctor to provide illness education and to resolve his family conflict. It was recommended that further research and clinical practice regarding caregiver role strain and mental illness education for school-aged children should be established.