照護一位思覺失調症外籍移工檢疫期間之護理經驗

Nursing Experience of Caring a Migrant Worker With Schizophrenia During COVID-19 Quarantine Period

黃展浩(Zhan-Hao Huang)；林美蓮(Mei-Lien Lin)

思覺失調症 ； 外籍移工 ； 檢疫隔離 ； 嚴重特殊傳染性肺炎 ； COVID-19 ； migrant worker ； schizophrenia

志為護理-慈濟護理雜誌

22卷5期（2023 / 10 / 01）

94 - 102

繁體中文;英文

本文為思覺失調症遠洋漁業移工，於船上因幻聽干擾、有怪異及攻擊行為，返臺隔離檢疫住院治療。照護期間自2020年12月16日至2021年1月27日，筆者經觀察、病歷查閱、翻譯機會談收集資料，以精神科五大層面評估，確認護理問題有自我照顧能力缺失、不遵從、危險性對他人暴力、知覺感受變異。因個案須檢疫隔離，啟動跨團隊照護，協助個案改善身體清潔；嚴守隔離措施；運用輔助工具，主動關懷建立關係；提供安全環境防範暴力、逃跑危機；觀察精神症狀，教導區分現實及幻覺，運用有效因應技巧應對幻聽；提供菲律賓文衛教單張，建立服藥遵從性，最後運用社會資源透過視訊聯繫案弟，以延續個案返國後的醫療照護。

This paper focuses on a migrant worker with schizophrenia including auditory hallucinations and violent behavior. The worker had returned to Taiwan to quarantine and accept medical treatment. The nursing period was from December 16th, 2020 to January 27th, 2021. The author collect data through case history and discussion which was analyzed with five perspectives of psychiatry, and confirmed nursing problems involving a deficiency in self-care, resistance to following instructions, violent behavior, and perceptual alterations. Given the case was in quarantine, and the nature of the disease, an across-team cooperative nursing plan was started. For instance, insure the cleanliness of the body, comply to quarantine measures, build up therapeutic relationship with the case and provide a safe environment to avoid violence, escape, and any problem situations. Additionally, an attempt was made to teach the case to observe mental states to help separate reality and hallucinations to cope with auditory hallucination. Thus, patient education in Filipino was given to increase medicine-taking obedience. Finally, in order to continue the medical treatment after return to Philippines, video calls was made to contact the case's brother in Philippines.

1. 王誱竩,林君黛(2019)。協助一位思覺失調症新移民女性跨文化適應之護理經驗。弘光學報，84，21-33。
   連結：
2. 梁莉芳(2019)。結構性脆弱的悲歌：外籍漁工的日常工作與健康經驗。人文及社會科學集刊，31(2)，263-300。
   連結：
3. 黃郁惠,齊偉先(2018)。罹患肺結核的移工在臺灣醫療照顧制度中的治療經驗與賦權。台灣公共衛生雜誌，37(1)，63-76。
   連結：
4. 趙梅光,洪翠妹,孫慧芳(2017)。照顧一位罹患思覺失調症新住民之護理經驗。精神衛生護理雜誌，12(2)，35-42。
   連結：
5. Kozloff, N.,Mulsant, B. H.,Stergiopoulos, V.,Voineskos, A. N.(2020).The COVID-19 Global Pandemic: Implications for People With Schizophrenia and Related Disorders.Schizophrenia bulletin,46(4),752-757.
6. Li, L.(2020).Challenges and Priorities in Responding to COVID-19 in Inpatient Psychiatry.PsychiatricServices,71(6),624-626.
7. Tiihonen, J.,Mittendorfer-Rutz, E.,Majak, M.,Mehtäl , J.,Hoti, F.,Jedenius, E.,Enkusson, D.,Leval, A.,Sermon, J.,Tanskanen, A.,Taipale, H.(2017).Real-World Effectiveness of Antipsychotic Treatments in a Nationwide Cohort of 29 823 Patients With Schiz ophrenia.The Journal of the American Medical Association Psychiatry,74(7),686-693.
8. 何芳慈,陳靜芳,陳昱芬(2017)。照護一位缺乏病識感的思覺失調症病人之護理經驗。澄清醫護管理雜誌，13(1)，64-73。
9. 陳軒毓,蘇渝晴(2018)。一位思覺失調症患者提供自主服藥訓練之照護經驗。澄清醫護管理雜誌，14(2)，58-67。
10. 勞動部勞動力發展署(2021，6月27日)．產業及社福外籍勞工人數-按行業及國籍分。取自https://statdb.mol.gov.tw/evta/jspProxy.aspx?sys=100%26kind=10%26type=1%26funid=wqrymenu2%26cparm1=wq14%26rdm=I4y9dcIi
11. 衛生福利部疾病管制署(2021，6月14日)，精神醫療機構因應COVID-19感染管制措施指引。https://www.cdc.gov.tw/File/Get/yUOB1OzVIpj211-fVZow0Q
12. 衛生福利部疾病管制署(2020，4月27日)，嚴重特殊傳染性肺炎疾病介紹。https://www.cdc.gov.tw/Category/Page/vleOMKqwuEbIMgqaTeXG8A
13. 蕭淑貞（校閱）(2019).精神科護理概論.華杏.