運用Rogers理論於一位重鬱症患者之護理經驗

Nursing Experience of a Major Depression Patient by Utilizing Rogers Theory

謝春滿(Chun-Man Hsieh) ； 柳家姳(Chia-Lo Liou) ； 張薰文(Shun-Wen Chang) ； 黃惠滿(Hui-Man Huang)

《台灣健康照顧研究學刊》 26期 (2022/07) Pp. 1-20

摘要

本文闡述運用Rogers護理理論於一位康復之家重鬱症患者成功回歸社區生活之照護經驗。護理期間為2021年7月5日－12月30日，以觀察、病歷查閱、身體檢查、會談方式收集個案資料，再藉由Rogers理論之原則進行護理評估，確立個案有不遵從、無效性因應行為、個人復原力障礙三項健康問題。筆者於照護期間持續關懷、接納及同理個案，協助個案覺察負向思考、不合適的因應行為，並鼓勵個案參與規律的生活作息，再搭配非侵入性護理措施（包括園藝、藝術治療），提昇個案參與活動的動機，提升治療遵從性及其疾病因應行為，進而改善個案憂鬱程度及與家人的關係。個案回歸社區返家後可規律服藥及回診。期許此護理經驗提供未來長期照顧重鬱症患者之參考。

關鍵字

重鬱症 ； 身心科病人 ； Rogers護理理論 ； 護理經驗

並列摘要

After patient returning to the community, we report the case of a patient with major depressive disorder in psychiatric halfway house and present our nursing experience by using Rogers nursing theory. During the period of care, data were collected from July 5 to December 30, 2021, using observation, medical record review, physical examination, interviews, and the principles of Rogers nursing theory. The following three health issues were identified: noncompliance, ineffective coping behavior, and insufficient resilience. We constantly used caring, acceptance and empathy skills to help the patient to aware negative thinking, and inappropriate coping behavior. Through this process, participation in regular lifestyle routines was encouraged; non-invasive nursing interventions (including gardening, art therapy) were implemented by nursing staffs. Through this process, participation in regular lifestyle routines was encouraged; non-invasive nursing interventions (including gardening, art therapy) were implemented by nursing staffs. By enhancing patient's motivation to participate in activities, improving treatment compliance and disease coping behaviors, thereby patient's depression level and relationships with family members were improved. After returning to the community, the patient could take medicine and visit OPD for advanced treatment, regularly. After returning to the community, the patient could take medicine and visit OPD for advanced care, regularly. It is hoped that this nursing experience could serve as a future reference for nursing colleagues in caring for patients with major depression.

並列關鍵字

major depression ； psychiatric patients ； Rogers theory ； nursing experience

參考文獻

林美珍、曾怡菱（2020）。〈燒運用認知治療照顧一位重鬱症復發病人之護理經驗例〉。《榮總護理》，第37卷第4期，頁393-400。Doi:10.6142/VGHN.202012_37(4).0008

吳雅婷、郭展宏、許凱倫（2013）。〈周全性老年評估個案報告：多重慢性疾病倂老年憂鬱及自殺行為〉。《台灣老年醫學暨老年學雜誌》，第9卷第4期，頁198-211。Doi:10.29461%2fTGG.201411_9(4).0005

陳雅玲、吳沁縈、 張祐銓、林昱呈、歐俞宏、 黃玠璋（2021）。〈園藝活動對社區老人身心健康效益之研究〉。《臺灣職能治療研究與實務雜誌》，第17卷第1期 ，頁39-51。Doi:10.6534/jtotrp.202106_17(1).00 04

黃淑儀、宋惠娟（2016）。〈憂鬱之概念分析〉。《榮總護理》，第33卷第2期 ，頁204-211。Doi:10.6142/VGHN.33.2.204

溫芯寧、吳宏蘭、郭倩琳、劉紋妙（2015）。〈應用藝術創作改善長照機構老人憂鬱及提升自尊〉。《護理與健康照護研究》，第11卷第4期 ，頁267-276。Doi:10.6225/JNHR.11.4.267