照顧一位思覺失調症個案因自殺導致嚴重創傷的護理經驗

本文主要探討一位思覺失調症個案因與家屬之間產生衝突憤而自殺造成嚴重創傷之護理經驗。護理期間自2018年5月29日至6月27日運用Gordon 11項健康功能型態，藉由與個案及家屬會談、觀察，收集資料發現個案主要有疼痛、身體活動功能障礙、家庭因應失能等健康問題。透過以家庭為中心的護理概念，建立良好的護病關係，提供個別性的護理指導與疼痛控制；偕同物理治療師擬定復健計畫及臨床心理師協助心理治療、召開家庭會議等措施，除改善個案疼痛及身體活動功能之問題外，更進一步提升個案自我照顧能力及協助個案與家庭成員重建正常的生活模式，避免類似意外再次發生。建議此類個案應盡早成立跨團隊聯合照護模式，運用整合跨團隊資源，使個案能獲得整體性評估與照護，協助個案及家屬解決問題，回歸和睦的家庭生活。

關鍵字

思覺失調症；自殺；嚴重創傷

並列摘要

This article focused on the nursing experience in a patient with schizophrenia who committed suicide from conflicts with his family. During nursing care, we used Gordon's functional health patterns to evaluate the patient. Through clinical observation and interviews with the patient and his family, the main caring issues were pain, physical dysfunction, and disabled family support. Via the concept of family-centered care, we established a good relationship between the patient and provided the individualized nursing care and pain control program. The collaboration with nursing and physiotherapists in developing rehabilitation plans, psychotherapist in psychotherapy, and communication with family further enhanced the self-care ability and assisted the patient and family in rebuilding a healthy lifestyle and avoiding the recurrence of episodes. Cross-disciplinary care should be implemented as early as possible in those patients involved with psychological and family conflicts. Under the assessment and integration of cross-team resources by the nurses, the patient can be evaluated and treated in an integrated and timely manner to help patients and their families solve their problems and return to a harmonious family life.

並列關鍵字

Schizophrenia ； suicide ； severe trauma patient

參考文獻

Fuller-Thomson, E., & Hollister, B. (2016). Schizophrenia and Suicide Attempts: Findings from a Representative Community-Based Canadian Sample. Schizophrenia research and treatment, 3165243. doi: 10.1155/2016/316524

台灣自殺防治學會（2018，10月4日）‧從公共衛生及精神醫療談自殺防治‧取自 http://tspc.tw/tspc/portal/index/index.jsp。