照顧一位品行疾患之護理經驗

Nursing Experience about Caring a Patient of Conduct Disorder

10.6692/KJN-2007-24-2-6

李素芳(Su-Fang Lee)；黃美意(Mei-Yi Hwang)

品行疾患 ； 問題解決訓練 ； 親子衝突 ； conduct disorder ； problem solving training ； parent-child conflict

高雄護理雜誌

24卷2期（2007 / 11 / 01）

72 - 84

繁體中文

本文乃探討一位品行疾患之青少年對雙親暴力的護理經驗，護理期間為2005年4月17日至2005年6月3日。筆者以整體性護理評估發現個案主要健康問題為：(1)個人因應能力失調。(2)家庭因應能力失調。因個案無法適應學校的課業壓力，要求轉學，其需求未獲滿足，出現對父母親有施暴情形，個案對此行為覺得理所當然。經筆者觀察個案的行為及表現，透過與個案、家屬建立的治療性人際關係，運用相關護理措施並採問題解決訓練的方式，探討親子衝突因應之道，共同討論問題核心點及協助解決問題，讓親屬之間表達對彼此感受與期望並達成共識。五週後，個案與母親之互動由不滿、憤怒之情境逐漸能以理性態度彼此接納，雙方可以溫和口語表達其內心感受，並以正向方式處理其相關問題。

This paper aims to discuss the nursing experience since 2005. 4. 17~2005. 6. 3 concerning an adolescent with conduct disorder including exhibiting violence toward his parents. The author used an integral nursing evaluation to found that the primary health problems of the patient were as follows: (1) dysfunction of personal adaptive ability; and (2) dysfunction of family adaptive ability. The patient had violent behavioral tendencies toward his parents ostensibly because he had asked for a transferral to another school due to his inablility to adapt to the pressure from this school, but his parent couldn’t meet his request. Consequently, he felt anger and acted out hia aggressive tendencies violently. The author observed the behavior of the patient, and established a therapeutic interpersonal relationship with him and his family using an appropriate family intervention strategy. Besides, the author also used relative strategies of nursing and problem-solving skills to discuss the coping strategies of the conflicts between the parents and the patient, and the basic problem about the conflict. The author let them express their feelings and expectations and facilitated their views to gradually draw closer to each other. After 5 weeks, the interaction between the patient and his mother changed from being upset and angry to receiving each others' opinion with respect and rational thinking. They were able to express their feelings with gentleness, and manage their problems in a positive and not destructive way.