運用自我管理概念協助一位合併思覺失調症及強迫症患者的護理經驗

Nursing Experience of Applying the Concept of Self-management to Care a Patient with Schizophrenia and Obsessive-Compulsive Disorder

林盈束(Ying-Shu Lin)

《馬偕護理雜誌》 15卷2期 (2021/07) Pp. 80-92

https://doi.org/10.29415/JMKN.202107_15(2).0008

摘要

本文目的在描述精神衛生護理人員依據中華民國精神衛生護理學會公告之社區精神衛生護理實務能力，慢性病自我管理概念運用於照護一位思覺失調症合併強迫症的社區個案。照護期間自2017年8月8日至11月8日，透過精神科五大層面的評估及家庭護理評估，發現個案有處理人際衝突的因應不良，還有睡眠早醒的問題，另外個案對精神疾病不瞭解而曾經數次停止服藥，顯示對疾病和藥物方面的認知不足，有疾病管理之照護需求，依其照護需求，提供個案生活自我管理及疾病管理等照護活動，護理目標為個案能察覺因疾病而有的健康問題、能表達願意執行自我管理的意願並執行疾病自我管理策略，建立個案病識感及執行疾病管理來促進社區融合。結果呈現精神衛生護理人員在協助個案運用自我管理的技巧下，個案能展現執行自我管理的意願，發展因應疾病的方法，並且促進個案與家人的溝通，本文結果建議精神衛生護理人員運用社區精神衛生護理能力照顧社區精神病患及其家庭，促進病患使用疾病自我管理技巧來提升社區生活的適應，在國內外精神衛生照護發展推向社區化的趨勢下，期許本文可做為精神衛生護理人員在照護、增進社區精神病患社區適應的參考。

關鍵字

思覺失調症 ； 強迫症 ； 慢性病自我管理 ； 社區精神衛生護理實務能力

並列摘要

This article aimed to describe a nursing experience applying the essential community psychiatric mental health nursing competence, which was established by Psychiatric Mental Health Nurses' Association, and the concept of self-management in chronic diseases to care for a patient with schizophrenia and Obsessive-Compulsive Disorder. This patient and his family were evaluated through psychiatric mental health nursing assessment, and received nursing care from August 8 to November 8, 2017. This patient needed to be helped to cope with the situation like interpersonal conflict, sleep issue and adherence to medications effectively through self-management. The goals for nursing care were to assist this individual in developing the self-awareness in problems linked to mental illness, and practicing his own coping strategies of self-management in daily life, and to improve his insight in schizophrenia. The results indicated that this patient showed his intention of practice self-management strategies and applied the skills to cope with his mental illness. Therefore, the essential psychiatric mental health competence and the self-management in chronic disease are recommended to utilize for increasing psychiatric patients' community adjustment.

並列關鍵字

schizophrenia ； obsessive-compulsive disorder ； self-management in chronic diseases ； community psychiatric mental health nursing competence

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