照顧一位罹患思覺失調症新住民之護理經驗

A Nursing Experience of Caring for a New Resident Suffering From Schizophrenia

10.6847/TJPMHN.201712_12(2).0004

趙梅光(Mei-Kuang Chao)；洪翠妹(Tsui-Mei Hung)；孫慧芳(Huey-Fang Sun)

思覺失調症 ； 新住民 ； Schizophrenic ； new resident

精神衛生護理雜誌

12卷2期（2017 / 12 / 01）

35 - 42

繁體中文

本文為照護一位罹患慢性思覺失調症新住民個案，19歲移民來台因壓力及適應障礙，導致在台發病，出現無法維持日常生活、喪失工作能力之護理經驗。護理期間為104年01月22日至104年6月29日，運用護理五大層面為評估架構，藉由會談、觀察及過去病史收集方式，歸納個案主要的護理問題有：「無效性自我健康管理」、「無效性因應能力」、「長期性低自尊」等。筆者以關懷、接納之態度，運用圖像式輔助工具及定時、耐心的個別化溝通，與個案建立良好信任的治療性人際關係，共同擬訂個別性護理計畫，分別運用自我服藥訓練、症狀因應衛教、循序漸進陪伴參與疾病及工作適應團體等措施，提升個案疾病的自我健康管理，及壓力因應與社交技巧能力，改善個案人際互動，增加自我肯定的經驗，進而增強自尊心及自我價值感。護理期間個案因中文能力不佳，說話口音讓人有點聽不清楚，又對環境感到陌生與害怕，故更需給予耐心的傾聽，並在疾病衛教中大量使用圖卡輔助，藉以增進個案之理解力，達到良好之衛教效果，建議未來醫護人員面對新住民個案可採取類似的護理策略。

This article is about taking care of an immigrated resident suffering from Schizophrenia. At the age of 19, she immigrated to Taiwan. Due to having pressure and adaptation disorders, she has been unable to maintain her daily life and to have capability to attend work, to carry out her work duties and to take care of daily routine when onset appeared for the first time. There are five nursing dimensions in the assessment structure made to a conclusion that the major nursing problems in this case should be blamed for ＂ineffective self-health management＂, ＂ineffective coping＂, ＂chronic low self-esteem＂, and so on from their interview, observation and disease history. I have tried to show a trusted attitude of willing to make a good relationship with her, and to encourage her to acknowledge her symptoms with concerns, acceptance, and later we developed together a treatment project. After giving her an individual nursing plan in accordance with her symptoms and sharing her with health education, offering courses for the disease adaptation groups and encouraging her to join in the activities, she has improved with better health to schizophrenia. During the nursing period of time, she gradually acquired many coping skills, and increased the ability to adapt with pressure. A partner by side, with patience following a step by step plan would help improve social interactions and social skills, help increase self-affirmation, and help deal with low self-esteem. Due to her accent and limited speaking ability in speaking Mandarin with fear of the environment, we have tried to slow down the speed and be attentive about what she said during this episode, and we have used to give her picture cards to assist her in understanding health education instead of merely an oral communication. We made a suggestion that we could take a similar health education strategy in taking care of an immigrant in the future.

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