運用紐曼系統模式於一位重覆自殺精神障礙個案之護理經驗

Applying Neuman's Model to a Psychiatric Patient with Repeated Suicidal Attempts

10.6692/KJN-2017-34-2-9

黃冠錦(Kuan-Chin Huang)；陳靜紋(Jing-Wen Chen)；黃文慧(Wen-Hui Huang)；蘇以青(Yi-Ching Su)

紐曼系統模式 ； 自殺 ； 重覆自殺 ； Neuman's systems model ； suicide prevention ； repeat suicidal attempts

高雄護理雜誌

34卷2期（2017 / 08 / 01）

97 - 107

繁體中文

本文為照顧一位2 個月內重覆自殺2 次之精神障礙個案護理經驗，護理期間自2015 年3月18 日至2015 年7 月18 日，筆者運用紐曼系統模式評估個人內在與環境、壓力源之相關性，以及自殺防治概念之危險、保護因子，確立健康問題為無效性因應能力、潛在危險性自殺、長期性低自尊。運用護理措施使個案能擴展彈性防禦線、增強正常防禦線和強化內在防禦線，來協助減少危險因子、強化保護因子以增加對壓力源的調適能力。護理成果是個案能辨識壓力情境、察覺內在資源、了解危機預防及管理資源，並能增加自我肯定，出院追蹤3 個月，個案都未再出現自殺行為，期望此護理經驗能做為照護自殺企圖個案之參考。

This article describes a nursing experience using Neuman's systems model for a psychiatric patient who exhibited repeat suicidal attempts within two months. The nursing process began on March 18th to July 18th, 2015. Nursing care was provided to the patient based on the Neuman's systems model, which included assessments of intrapersonal, interpersonal, and extra-personal forces as well as of environmental factors affecting the stressor of the patient as well as suicide prevention to decrease suicide risk and increase protective factors. The patient presented with three health problems: ineffective coping, risk for suicide, and chronic low self-esteem. Following Neuman's systems model, strategies were used to strengthen the flexible lines of defense, internal lines of resistance, and support existing strengths of the patient to find intra-resources to decrease suicide risk and increase protective factors. The patient could identify stressful situations and perceive intra-resources to learn crisis-coping strategies, management resources and increase self-affirmation in nursing intervention outcomes. She had resisted committing suicide at follow-up 3 months after discharge. We hope this provides a successful nursing care reference.