運用行為治療照護措施於一位失智症合併自傷個案之護理經驗

Nursing Experience of Applying Behavioral Therapy Intervention to a Merger Dementia Case Combined with Self-Injury

黃依婷(Yi-Ting Huang) ； 蘇千玲(Chien-Ling Su)

《高雄護理雜誌》 37卷2期 (2020/08) Pp. 106-119

https://doi.org/10.6692/KJN.202008_37(2).0010

摘要

本文為照護一位患有失智症老年病人，因深受憂鬱、負向思考、焦慮而反覆出現自傷行為護理經驗。照護期間自2017年7月24日至2017年8月23日，採用自殺意念十分評估量表、焦慮十分評估量表、貝氏憂鬱量表，以及進行精神科五大層面整體性評估收集資料，護理問題為：（一）高危險性對自己的暴力攻擊行為／與憂鬱情緒有關。（二）焦慮／與擔心睡眠有關。（三）個人因應能力失調／與缺乏適當因應技巧有關。因此筆者運用行為治療協助矯正不當行為的發生，減少出現自傷的負向想法與行為，同時透過建立良好治療性溝通技巧取得其信任，採傾聽、同理其感受與陪伴來照顧病人，從中教導學習放鬆方法達到緩解焦慮情形，針對問題導因協助正向思考提升因應能力。

關鍵字

行為治療 ； 失智症 ； 自傷

並列摘要

In caring for an elderly patient with dementia, this article illustrates the nursing experience of repeated self-injury behaviors due to depression, negative thinking and anxiety. During the period of care from July 24, 2017 to August 23, 2017, the Suicidal Ideation Assessment Scale, the Anxiety Assessment Scale, the Bayesian Depression Scale, and the Psychiatric Five-Level Global Assessment were collected. The questions were: (1) High risk of violent aggression against oneself / related to depression; (2) Anxiety/related to worry about sleep; and (3) The individual's ability to respond to disorders related to the lack of appropriate response skills. Accordingly, the author used behavioral therapy to help correct the occurrence of misbehaviors, reduce negative thoughts and behaviors of self-injury, and at the same time, gain trust by establishing good therapeutic communication skills in taking care of the patient by listening, empathizing with his feelings and providing companionship while teaching him from this. For this case, teaching relaxation methods could alleviate anxiety and assist in development of positive thinking to improve his ability to respond to the cause of the problem.

並列關鍵字

behavioral therapy ； dementia ； self-injury

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