提升一位佐沛眠藥物濫用失眠患者因應能力之護理經驗

A Nursing Experience of Improving the Coping Capability of an Insomnia and Zolpidem Drug Abuse Patient

10.6847/TJPMHN.201212_7(2).0006

鄭喻丰(Yu-Fong Cheng)；楊芝菁(Tzu-Ching Yang)

失眠 ； 睡眠障礙 ； 佐沛眠 ； 藥物成癮 ； 睡眠品質 ； insomnia ； sleep disorder ； zolpidem ； drug addiction ； quality of sleep

精神衛生護理雜誌

7卷2期（2012 / 12 / 01）

41 - 48

繁體中文

本文為照顧一位因長期失眠困擾導致服用過量助眠劑而再次住院患者之照護經驗。護理期間為2011年9月26日至2011年10月19日，運用病歷資料分析、會談、觀察、實際照護及整體性護理評估收集資料。歸納個案主要之護理問題為一、睡眠型態度紊亂／因預期性焦慮、錯誤失眠認知及因應行為、不正確失眠藥物認知所致；二、個人因應能力失調／因缺乏覺察生活壓力事件之影響、不良壓力因應技巧所致。以關懷、陪伴、接納的態度與個案建立良好治療性人際關係，引導討論生活壓力事件對睡眠之影響，及覺察過去不成熟之壓力因應方式，教導正確因應失眠問題之方法，最後個案能運用正確因應失眠之方法，透過覺察及表達對生活壓力事件的想法與感受後，逐漸瞭解到父親的關愛及父親對其長期服用過量安眠藥導致昏睡或倒地不醒等副作用之擔憂，學習與父親溝通後，除修復因彼此不諒解而終止的收養關係外，改善後的親子關係也激發個案自我改變之動力，進而配合醫師處方調降安眠藥物劑量，亦重新規劃金錢管理及使用方法，於出院前其因應壓力及失眠問題之能力明顯提升。

This article is to report a nursing experience of enhancing the coping capability of a zolpidem drug abuse patient who has suffered from long-term insomnia. Based on a comprehensive psychiatric nursing assessment, the patient's two major health problems included disturbed sleeping pattern and ineffective coping skills. The author initially approached the patient with a sincere, compassionate and accepting attitude to establish a therapeutic relationship. Subsequently, the author discussed with the patient how stressful life events have had an impact on their behavior. These topics included the patient's interpersonal and familial relationships and the ineffective coping skills utilized by the patient in the past. This discussion revealed that the patient struggled with her relationship with her step-father. To effectively facilitate a resolution of the patient's concerns, methods to improve self-awareness and relaxation techniques were introduced in conjunction with an adjustment in the dosage of zolpidem. Improved coping skills enable the patient to react to the same psychological stressors with comfort and ease when facing a stressful situation. We hope share this nursing experience of improving the patient having long-term insomnia with other nursing professionals.