運用個別懷舊治療於老年憂鬱症病人之護理經驗

A Nursing Experience of Applying Individual Reminiscence Therapy to an Elderly Patient with Depression

莊祐綸(Yu-Lun Chuang) ； 劉曉君(Hsiao-Chun Liu) ； 陳祐蓉(Yu-Jung Chen)

《新臺北護理期刊》 22卷2期 (2020/09) Pp. 119-129

https://doi.org/10.6540/NTJN.202009_22(2).0011

摘要

本文係探討一位71歲重度憂鬱症病人，因情緒低落，多負向想法，且重複出現自傷行為，兩年內住院了5次，筆者於2016年08月21日至09月09日期間，運用生理、心理、智能、社會及靈性等五大層面整體性評估為架構來收集資料，確立病人有長期性低自尊、社交互動障礙、潛在危險性自殺等問題。照護過程運用個別懷舊治療方式，依照病人過去生活、興趣、職業等，設計了6次懷舊主題，每次30分鐘，鼓勵病人訴說並接納其內心感受及想法，並藉由懷舊過程促使病人找回自我價值及自信心，同時減少病人負向想法及自殺意念。在懷舊治療執行後，評估病人情緒明顯改善，與家人互動更為頻繁，也可主動參與社交活動。此外，藉由提供家屬對憂鬱症認知及懷舊治療之執行技巧，使其能增強家庭支持，亦可於出院返家後延續懷舊活動之參與，提升病人正向能量，減少重複住院次數。期許藉此護理經驗提供臨床照護老年憂鬱症病人能有更多非藥物治療之選擇，也建議護理人員能熟悉懷舊治療技巧並運用於實務工作中，將有助於病人早日回歸社區恢復過往生活型態。

關鍵字

懷舊治療 ； 憂鬱症 ； 老年

並列摘要

This article described a 71-year-old patient with major depression who was hospitalized five times in two years due to depressed mood, more negative thoughts, and repeated self-injury. From August 21^(st) to September 9^(th), 2016, the author collected data by using five different aspects - physical, psychological, mental, social and spiritual - as a comprehensive assessment framework to identify the patient's problems of long-term low-esteem, impaired social interaction, and the potential risk of suicide. The care process used individual reminiscence therapy for 30 minutes each time and designed six reminiscence themes according to the patient's past life, interests, occupations, encouraging the patient to express and accept his inner feelings and thoughts, urging patient to rebuild his confidence and regain his self-worth, and reducing the patient's negative thinking and suicidal ideation. After the reminiscence therapy, the patient's mood significantly improved; the interaction with the family become more frequent; and the social activities can be actively participated. Additionally, by providing family members with knowledge of depression and reminiscence therapy, the patient could enhance family support, continue to participate in reminiscence activities after returning home, improve the patient's interest in life, and reduce the number of repeated hospitalizations. It is hoped that this nursing experience will provide more care for elderly patients with depression and more non-drug treatment. It is also recommended that nursing staff should be familiar with reminiscence therapy skills and apply it to practical work, which will help patients return to the community as soon as possible to restore their past life style.

並列關鍵字

reminiscence therapy ； depression ； elder

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