協助一位青少年因應戒菸壓力之護理經驗

A Nursing Experience in Helping an Adolescent to Cope with the Stress of Quitting Smoking

林奕彤(Yi-Tong Lin) ； 丘周萍(Chou-Ping Chiou)

《源遠護理》 3卷2期 (2009/11) Pp. 81-91

https://doi.org/10.6530/YYN.2009.3(2).10

摘要

本文旨在探討一位青少年因學業挫折、家庭衝突的壓力及受同儕團體影響而開始吸菸至被家人逼迫戒菸的護理經驗。收案期間藉由觀察、會談等方式，將護理過程記錄加以整理、分析並運用羅氏適應模式評估個案在生理調適、自我概念、角色功能、相互依賴等層面的健康資料及第二層次三種刺激，發現主要的健康問題有：無效性因應能力、親職功能障礙、情境性低自尊、及營養不均衡：少於身體需要。
當筆者發現個案吸菸的動機除了好奇外，更隱藏著個人的家庭壓力、學習挫折、以及長期以來不被家人及師長的信任等壓力，因而以吸菸來印證自己價值的存在和得到同儕團體的認同，且在個案戒菸過程中學業成績及行為有明顯改善時又遭家人及師長不信任與嚴重質疑的壓力。為深入瞭解個案的內心世界及協助個案戒除吸菸行為，護理人員提供主動傾聽、愛與關切的情緒支持、對於失落表達同理心、肯定個案的自我價值與自我尊嚴，並以行為改變技術提供個案個別化及合適之戒菸護理措施，使個案能有信心自我調適，進而成功戒除吸菸以達到身心適應。期望此篇以羅氏適應模式理論為基礎的護理經驗，能提供護理人員在協助青少年戒菸適應過程時之參考。

關鍵字

青少年 ； 戒菸 ； 家庭衝突 ； 行為改變技術

並列摘要

The purpose of this case report is to describe the nursing experience of a teenager who started smoking because of frustration with school work and peer influence. The subject was ultimately forced to quit smoking by his family members. These authors collected data through observation and interview, and analysed the process recording. The Roy's Adaptation Model was used to assess the physiological adjustment, the self-concept, the role function, and the interdependence modes of the case, and the problems of this case that were identified as ineffective coping, impaired parenting, low situational self-esteem and imbalanced nutrition: less than body requirements.
This report shows that curiosity was not the only reason why this teenager started to smoke. Pressure from the family, frustration from the school work, and the stress of long-term distrust from both family and teachers ultimately pushed the teenager to prove his own value through smoking. In addition, when this teenager made significant improvements in school work and the stop-smoking process, he was even further distrusted and doubted by his family and teachers. To better understand this teenager and assist him in quitting smoking, the authors provided several customized services, including listening actively, using love and caring emotional support, expressing empathy to his loss, affirming his self-value and self-dignity, as well as using behavioral modification. These services increased the teenager's confidence and helped him to adjust his behavior and successfully quit smoking. We hope the nursing results in this study, which are based on the adaptation model theory, could serve as a reference for nursing staff when helping teenagers during the adapting stage of the stop-smoking process.

並列關鍵字

Adolescent ； quit smoking ； family conflict ； behavioral modification