護理一位罹患精神分裂症之新移民之子的經驗

A Nursing Experience of an African-Taiwanese Who Suffered from Schizophrenia

10.6847/TJPMHN.201310_8(1).0006

熊子瑜(Tzd-Yu Hsiung)；葉玉汝(Yu-Ju Yeh)；楊子慧(Tsu-Hui Yang)

精神分裂症 ； 新移民家庭 ； 行為修正 ； 社交技巧訓練 ； Behavior Modification ； Foreign Family ； Schizophrenia ； Social Skill Training

精神衛生護理雜誌

8卷1期（2013 / 10 / 01）

40 - 50

繁體中文

本文為陳述一位罹患精神分裂症的新移民之子，因疾病功能退化及依賴家屬照顧，導致自我照顧與社交能力缺失。其主要照顧者為非裔父親，在協助病人就醫過程因語言文化隔閡，無法尋求資源，長時間的照顧感到疲累。護理期間為100年5月3日至100年11月30日，以五大層面整體評估，運用會談、觀察、電訪及病歷回溯方式收集資料，確立健康問題為：自我照顧能力缺失、社交互動障礙、危害性家庭因應能力失調。運用行為修正並與案父以分工合作方式，教導病人學習沐浴；藉由社交技巧訓練，以示範、重覆練習、回饋與正增強方式，增加言語表達及與人互動關係；評估家庭情況及父母之照顧能力，提供有利病人的持續性醫療資源及教導家屬分工合作方式對病人的照顧；促進家庭成員互相溝通支持。結果：病人從完全由案父協助沐浴，轉變成督促下可自行執行沐浴；從不語、雙眼緊盯他人，現可用簡單詞句表達自己的需要，並和病友有簡短互動及全程參與團體活動；病人與父母正向互動增加，案父母的照顧方式亦有所改變，調整成協助病人獨立執行自我照顧與增加合宜社交技巧。由此護理經驗，建議臨床工作人員，面對新移民家庭，須更有耐心傾聽，並尊重其文化差異，才能提供適切之照護。

This article describes a nursing experience of an African-Taiwanese who suffered from schizophrenia. Because of the disease, the patient's physical functions deteriorate and must mainly rely on his family members to look after him. However, the workload made his father exhausted after long-hour caring, who didn't know where to seek resources for assistance owing to language barriers. The nursing period started from May 3rd to November 30th of 2011. The data of the patient's progress were collected through interview, observation, and phone calls, in which relevant nursing assessments were conducted in accordance with five major aspects. Afterwards, we established the patient's health problems as follows: self-care ineffectualness, impaired social interaction, and disabled family coping ability.We adopted behavior modification methods, and cooperated with her family to instruct the patient how to take a bath. Besides, we improved his social skill and interaction by demonstration, practice, feedback and positive reinforcement techniques. Moreover, we provided the family with information of persistent medical care. We also help modify the ways that the family members used to take care of the parent, and further encouraged them to share experiences and communicate with each other. Finally, the patient could take a bath by himself, and be able to express his needs by simple expressions from starring at people with silence at the very beginning and gradually took part in group activities. In other words, the patient's interpersonal relationship was enhanced, so did the family members' caring skills. It is the technique that integrates independent self-help care with improved social capability. From the nursing experience, we thus suggest that clinical staff while facing new-immigrating families should pay more attention to listen to their needs with patience, and respect their culture features, in order to provide appropriate care.