運用人際社交節奏治療於雙相情緒障礙症患者之護理經驗

A Nursing Experience of Applying Interpersonal and Social Rhythms Therapy to a Patient with Bipolar Disorder

10.6847/TJPMHN.202012_15(2).04

何真利(Chen-Li Ho)；吳寶瑜(Pao-Yu Wu)

雙相情緒障礙症 ； 人際社交節奏治療 ； 服藥結盟 ； Bipolar disorder ； Interpersonal and Social Rhythms Therapy ； Medical alliance

精神衛生護理雜誌

15卷2期（2020 / 12 / 01）

40 - 50

繁體中文

本文敘述一位雙相情緒障礙症個案，運用人際社交節奏治療之護理經驗。筆者於照護期間2016年11月25日到2017年2月15日，運用觀察及會談技巧進行整體性護理評估，歸納出主要健康問題有：服藥結盟不足、營養多於身體需要、無效性因應能力及家庭因應能力失調。這些問題行為常源自於情緒調適能力差、衝動控制不足及人際關係障礙。護理照護期間，筆者首先以陪伴、支持及尊重態度，與個案建立治療性人際關係，然後運用人際社交節奏治療，引導個案自我覺察不穩定社交節奏、人際關係與疾病之間密切相關，調整不適切人際互動及建構規律生活作息。最後，個案情緒及人際關係漸趨穩定，避免疾病復發及再住院。建議護理人員可於門診或居家期間，教導個案覺察其不穩定的社會節奏。

The purpose of this paper is to describe a nursing experience of using Interpersonal and Social Rhythms Therapy to a patient with bipolar disorder. The patient has received nursing care from November 25, 2016 to February 15, 2017. Nursing assessments were holistically undertaken through observation and communication. Nursing problems have been identified as poor medical alliance, excessive nutrition more than bodily needs, and ineffective personal coping skill to get along with family members. These behaviors aforementioned usually come from poor self-emotional adjustment, insufficient self-control, and interpersonal barriers. During the nursing care process, we have firstly established a therapeutic interpersonal relationship with the attitude of alliance, support and respect. The interpersonal social rhythm treatment was used to guide the case to detect the unstable social rhythm, and interpersonal relationship, motivate the patient to adjust their interpersonal interaction and to construct regular life routines. The outcomes of nursing care showed that the improvements in self-control, emotional stability and interpersonal relationships, and quality of life which lead to reduce the relapse and rehospitalization. Thus, learning how to monitor their unstable social rhythms is suggested.

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