運用整合性家庭評估於社區復健中心精神分裂症病患家庭之照護經驗

Applying an Integrated Family Assessment Tool for Schizophrenic Patients in a Community Rehabilitation Center

10.6692/KJN-2011-28-1-7

張瑞香(Jui-Hsiang Chang)；賴倩瑜(Chien-Yu Lai)

家庭評估 ； 社區復健 ； 精神分裂症 ； Family Assessment ； Community Rehabilitation ； Schizophrenia

高雄護理雜誌

28卷1期（2011 / 04 / 01）

70 - 82

繁體中文

在社區之精神病患，常受殘餘症狀之苦，又因疾病症狀的限制，常與家人無法溝通，間接引發家屬照顧上的問題與困難，最後則導致病患的重複住院。本文主要運用整合性家庭評估於社區復健中心精神分裂症病患之家庭，護理時間為期5個月。在接案之初，發現個案仍受疾病症狀的影響，且其表現與個案家屬的疾病復健認知有落差，因而復健過程參與度差、反覆住院。作者透過一整合式的家庭評估工具，其融合Wright及Leahey (2000) Calgary Family Assessment Model及Friedman，Bowden，& Jones (2003)的家庭評估模式(Family Assessment Model)，以進行整合性的家庭評估與分析，發現個案的護理問題有「知覺感受改變：幻聽」、「社交互動障礙」及「無效性因應能力」；而其家庭的護理問題有「家庭成員間不適當的責任分配」及「照顧者角色緊張」，藉由完整護理計畫的提供，改善個案及家庭的護理問題，並促進家庭的健康成長。

The purpose of this case study was to test a new integrated family assessment tool for schizophrenic patients in a community rehabilitation center. The Calgary Family Assessment Model (Wright & Leahey, 1994) and Family Assessment Model (Friedman, 2003) were merged as a new tool in this case study. Structure data were collected, such as the patient’s general family background, developmental tasks at the certain stage of the family, family structure, family function and family adaptation in accordance with the integrated assessment tool. Since the family was treated as a holistic unit, psychiatric nurses may promptly and thoroughly understand the family's operational functioning and clearly identify the health problems of the patient and his/her family by using the new tool. The new family assessment tool offers a more holistic view for psychiatric nurses in taking continuous care of the psychiatric family in the community.

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