運用精神居家護理服務於失智症之照護經驗

Nursing Experience for Dementia by Applying Psychiatric Home Care Services

10.6692/KJN.202408_41(2).0008

蘇淑敏(Shu-Min Su)；黃文慧(Wen-Hui Huang)；蔡佳吟(Chia-Yin Tsai)

失智症 ； 照顧者角色緊張 ； 精神居家護理 ； dementia ； caregiver role stress ； psychiatric home care

高雄護理雜誌

41卷2期（2024 / 08 / 01）

82 - 93

繁體中文;英文

本文探討一位失智症合併精神症狀的高齡婦女，照顧者是年邁配偶和看護工之精神居家護理經驗。護理期間2018年11月14日至2019年2月20日，經由8次居家訪視及20次電話訪問，以社區精神衛生護理評估確立健康問題為慢性混亂及照顧者角色緊張。將照顧者納入護理計劃，採用護理諮商了解現狀，實施個別護理計劃，逐步增加對疾病認知、建立藥物配合度和調整規律生活，通過提供學習環境設計、精神症狀因應技巧和運用社會資源，結果顯示，透過創造一個規律活動和配合藥物的熟悉環境，同時模擬與患者正確使用的溝通技巧，可以促進患者症狀穩定性、減少了家庭衝突和照顧者角色緊張，進而增加家庭互動和提升精神居家護理品質，故分享此護理經驗。

This article discusses the psychiatric home care experience of an elderly woman with dementia and mental symptoms for whom the caregivers were an elderly spouse and a foreign care worker. During the nursing care for the period between Nov, 14, 2018 to Feb 20, 2019, eight home visits and 20 telephone interviews were performed, identifying health problems as chronic chaos and role strain of caregiver with community mental health nursing assessments. By incorporating the caregivers into care plans, using care counseling to understand the current situation, implementing individual plans, gradually increasing the cognition of symptom, establishing medication adherence and adjusting life routines, and by providing a learning environment design, symptom coping skills exercises and use of social resources. The results showed that in creating a familiar environment with regular activity and medication adherence, while modeling proper use of communication skills with patient, the stability of the patient's symptom could be promoted, family conflicts and the burden of caregivers were both reduced leading to positive family interaction and improvement in the quality of psychiatric home care, accordingly, we wish to share this nursing experience.

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