- 期刊
協助一位慢性精神分裂症患者復健之護理經驗
The Nursing Experience of Assisting a Chronic Schizophrenic Patient in Rehabilitation
摘要
本篇報告係描述照顧一位不遵從服藥的慢性精神分裂症患者，從住院到進入庇護性工作職場之護理經驗。此患者因缺乏病識感及不遵從服藥，導致多次疾病復發及重複住院。筆者於照顧期間經整體性護理評估收集資料後，確立其護理問題為：未規則服藥、社交互動的障礙、及個人因應能力失調。藉由治療性信任及同盟關係的建立，傳達關心與接納；並尊重及參與其宗教信仰，鞏固其持續接受治療的動機；同時監測服藥行為及反應、改善藥物副作用、提供護理指導，促進對疾病及藥物的認知，並正確接受藥物治療。且提供患者工作技能復健訓練，進而投入醫院庇護性職場工作，以增進其生活功能。藉由多項護理措施的介入及回饋，使得個案願意持續接受藥物治療，面對挫折的處理能力增加，與他人能有合宜之互動，並從工作情境中提升其自尊及獨立生活的能力。
並列摘要
This case report describes the experience of nursing from hospitalization to supportive employment a chronic schizophrenic patient with poor medication compliance. The patient's lack of insight and poor medication compliance was resulting in symptom relapse and repeated hospitalization. By means of a comprehensive nursing assessment and data collection during the nursing period, the authors ascertained the nursing problems as poor medication compliance, impaired social interaction, and ineffective individual coping. The establishment of therapeutic trust and allegiance conveyed to the patient the nurses’ concern for and acceptance of him. Their respect for and sharing in his religious beliefs consolidated his motivation towards continuous medical intervention. At the same time, the nurses monitored the patient's behaviors and responses to medication compliance, ameliorated the side-effects of medication, and provided nursing guidance to enhance his understanding of his illness and medication, as well as helping him to accept treatment with medication. In addition, the patient was provided with rehabilitative working skills training, to enable him to progress to supportive employment in the hospital and to improve his living functions. As a result of various nursing interventions and his own feedback, this patient became willing to accept medication, to enhance his capacity to cope with frustration, to interact with others appropriately, and to promote both his self-esteem and, from his work environment, his capacity to live independently.
延伸閱讀
- 翁靖惠、陳玟伶（2020）。提升一位慢性思覺失調症病人復原力之護理經驗。護理雜誌，67(1)，113-119。https://doi.org/10.6224/JN.202002_67(1).14
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- 黃惠敏（2010）。一位精神分裂症患者於日間住院復健護理經驗。彰化護理，17(4)，25-37。https://doi.org/10.6647/CN.17.04.11
- 李雅芬、許敏桃（2012）。運用充能協助一個慢性精神分裂症患者家庭之護理經驗。長庚護理，23(1)，124-133。https://doi.org/10.6386/CGN.201203_23(1).0014
- 陳軒毓、蘇渝晴（2018）。The Nursing Experience of a Schizophrenic Patient After Training for Self-Administration of Medication。澄清醫護管理雜誌，14(2)，58-67。https://www.airitilibrary.com/Article/Detail?DocID=18136702-201804-201804030010-201804030010-58-67