照護一位失智症合併精神行為症狀患者之經驗

A Nursing Experience of Caring for a Demented Patient with Impaired Mental Status

本文旨在探討失智症合併精神行為症狀息者之護理經驗。作者於2012年3月19日至4月13日，藉由直接護理、觀察、會談、查閱病歷記載進行資料收集，同時運用精神科護理五大層大面之整體性護理分析歸納出共四個護理問題，分別為：進食、沐浴及衛生自我照顧能力缺失、潛在危險性跌倒、記憶功能障礙及思考過程紊亂等。透過治療性關係之建立、結構化的生活作息、環境治療及現實導向的護理措施後，個案之自我照顧能力、定向感及記憶力獲得提升，並減少精神行為症狀之發生。期望藉由本文之護理經驗分享能提供護理人員於照護相關個案之參考。

This case report presents the nursing experience for caring for a demented patient with impaired mental status. The nursing period was from March 19 to April 13, 2012. Data were collected through direct care, observation, interview, and medical chart review. The use of an integrated nursing assessment in the five dimensions of psychiatric nursing identified four main problemsself-care deficiency (such as adequate fluid intake), the potential risk of falling, impaired memory, and disturbed thought processesamong others. The provided nursing interventions included building a therapeutic relationship, structuring daily life routines, and providing milieu therapy and reality-orientation. The patient's self-care ability, sense of orientation, and memory all improved. The occurrence of mental disorder also decreased. The author expects that sharing this experience may serve as a reference for nurses taking care of demented patients with similar symptoms.