- 期刊
一位思覺失調症病人之護理經驗
Nursing Experience of Caring for a Patient with Schizophrenia
摘要
本文描述照護一位慢性思覺失調症，有幻聽、妄想及缺乏病識感病人的護理經驗。護理期間自2018年1月9日至6月12日止，筆者藉由直接觀察、治療性會談及查閱病歷等方式收集相關資料，並依病人生理、心理、智能、社會及靈性五大層面進行整體性評估，歸納病人有：感覺知覺紊亂、無效性因應能力及無效性健康維護等健康問題。護理過程運用關懷、傾聽及陪伴等方式，與病人建立良好人際關係及信任感。瞭解病人的需要及困難，教導分辨幻聽、妄想與現實情境的區別，並學習因應技巧；藉由服藥訓練，澄清病人對疾病和服藥過程中的感受，讓病人瞭解疾病治療及藥物相關知識，提升藥物治療動機及健康維護能力，減少反覆發病住院。建議未來對於反覆發病住院的病人，入院初期即規劃出院準備服務方向，提供各式社區復健治療模式之醫病共享決策，由病人、家屬及醫療團隊共同討論，決策出病人後續治療模式，期望減少病人再度住院及降低機構化的情形，早日回歸並適應社區的生活型態。
並列摘要
This study describes the nursing experience of caring for a patient with chronic schizophrenia, hallucinations, delusions, and lack of insight. The nursing period was from January 9 to April 1, 2018. The author used direct observations, therapeutic interviews and chart review to collect relevant data. Moreover, the author also performed an overall assessment on five major aspects including physiological, psychological, intellectual, social, and spiritual aspects in order to summarize the health problems encountered by the patient: sensory disturbance, ineffective response ability and ineffective health maintenance. During the nursing period, the author used methods such as caring, listening, and accompanying to develop a good interpersonal relationship with the patient and create a sense of trust. After understanding the patient's needs and difficulties, the author taught the patient how to distinguish between hallucinations, delusions and reality, and learn coping skills. Medication administration training was further provided to clarify the patient's feelings about disease and the medication administration process and enable the patient to understand the knowledge concerning disease treatment and medications to improve motivation to receive medication treatment and ability to maintain health, as well as to reduce repeated onset and hospitalization. It is advised that nurses plan for discharge preparation service directions at the initial stage of hospitalization for patients experiencing repeated onsets and hospitalizations in the future, as well various community rehabilitation treatment models and doctor-patient shared decision-making be provided to enable patients, family members and medical teams discuss together and make mutual decisions about the patient's subsequent treatment model. Hopefully, readmission and institutionalization of patients can be reduced to help them return and adapt to the lifestyle in the society at an earlier stage.
參考文獻
延伸閱讀
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