協助一位鬱症患者調適喪失同性伴侶哀傷之護理經驗

Nursing Experience in Supporting a Depressed Patient in Adapting to the Grief of Losing a Same-Sex Partner

10.6692/KJN.202404_41(1).0013

吳宗祐(Tsung-Yu Wu)；吳莉喻(Li-Yu Wu)

哀傷 ； 家庭運作 ； 憂鬱症 ； Influenza ； grief ； family process ； depression

高雄護理雜誌

41卷1期（2024 / 04 / 01）

158 - 169

繁體中文;英文

本文敘述一位缺乏家庭支持之男同性戀憂鬱症個案調適哀傷之護理經驗，筆者於2022年3月1日至29日運用五大層面評估，確立個案有「適應不良的哀傷／與無法接受失去重要伴侶有關」及「家庭運作失常／與家庭對成員的個別性尊重不足有關」等主要健康問題。護理過程中運用哀傷輔導原則，協助個案完成哀悼的四個任務和接受喪失伴侶之事實；並採用家庭復原力理論引導家庭成員參與照護。期望藉由此護理經驗之分享，提供護理同仁對於如何提升同性戀個案家庭支持度與如何照護哀傷個案之參考。建議未來在照護此類型個案時，能夠與個案及家屬培養具信任的治療性關係為最首要，以協助雙方表達彼此的愛與關懷和共同作出決策。

This article reports on the nursing experience of a male homosexual depression case who lacked family support to adjust to his grief. A five-dimensional assessment was conducted from March 1 to 29, 2022, to determine the major health issues of "maladaptive grief/associated with the inability to accept the loss of a significant partner" and "dysfunctional family functioning/associated with inadequate respect for the individuality of family members". Nursing care incorporated the principles of grief counseling to support the case in fulfilling the four tasks of grieving and accepting the truth of partner loss. Furthermore, the family resilience theory was applied to guide his family members' involvement in the caregiving process. It is expected that this study will serve as a reference for caregivers on how to enhance family support in homosexual cases and how to care for individuals experiencing grief. Recommendations for future caregivers in this type of case include developing a trusting therapeutic relationship between the case and his/her family to help both parties express their love and care for each other and further decision-making together.

1. 郭宇晴、王桂芸（2021）•家庭復原力之概念分析•源遠護理，15（2），28-34。
   連結：
2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
   連結：
3. Levi-Belz, Y., Gilo, T. (2020). Emotional distress among suicide survivors: The moderating role of self-forgiveness. Front Psychiatry, 11, Article 314. https://doi.org/10.3389/fpsyt.2020.00341
   連結：
4. Monroe, S. M., Anderson, S. F., & Harkness, K. L. (2019). Life stress and major depression: The mysteries of recurrences. Psychological Review, 126(6), 791-816. https://doi.org/10.1037/rev0000157
   連結：
5. Supiano, K. P., Larsen, P., Riley, C., Hutton, A., Iacob, E., Walker, A. M., & Morrison, S. J. (2021). Complicated grief group therapy for community-residing persons diagnosed with serious mental illness. Social Work in Mental Health, 19(5), 381-402. https://doi.org/10.1080/15332985.
   連結：
6. Walsh, F. (2002). A family resilience framework: Innovative practice applications. Family Relations, 51(2), 130-137. https://doi.org/10.1111/j.1741-3729.2002.00130.x
   連結：
7. Wang, Y., Lao, C. K., Wang, Q., & Zhou, G. (2022). The impact of sexual minority stigma on depression: The roles of resilience and family support. Sexuality Research and Social Policy, 19(2), 442-452.
   連結：
8. Wilks, C. R., Morland, L. A., Dillon, K. H., Mackintosh, M.-A., Blakey, S. M., Wagner, H. R., & Elbogen, E. B. (2019). Anger, social support, and suicide risk in U.S. military veterans. Journal of Psychiatric Research, 109, 139-144. https://doi.org/10.1016/j.jpsychires.2018.11.026
   連結：
9. Worden, J. W. (2018). Grief counseling and grief therapy: A handbook for the mental health practitioner (5th ed.). Springer.
   連結：
10. 李玉嬋、李佳霖、楊美娟、鍾瑞容（2020）•車禍驟逝創傷性死亡與選擇寬恕及減壓悲傷輔導•諮商與輔導，(411)，44-47+16。
11. 蔡碧藍（2022）‧情感障礙病患之護理‧於葉美玉總校閱，精神科護理學（十版，300-354頁）‧高立。
12. Kim, G. M., Lim, H. S., Lim, J. Y., Kim, S. S., Kim, E. J. (2019). Effects of a Family Resilience Enhancement Program (FREP) on family adaptation to elderly with dementia in south Korea. International Journal of Gerontology, 13, 54-58. https://doi.org/10.6890/IJGE.201903_13(1).0011