應用Peplau人際關係理論於操縱行為病人之護理經驗

Application of Peplau’s Theory in the Nursing Care of the Patient with Manipulative Behavior

本文呈現一位躁症患者合併有操縱行為之護理經驗，護理期間自92年12月4日至12月31日。文中採用Peplau人際關係理論經由介紹期、認同期、探索期、解決期等四個護病關係的互動時期。由評估中發現個案有不信任他人、不安全感、害怕親密關係、以及因內心焦慮而引發負向病態心理防衛機轉，導致護病關係不良。護理人員運用治療性人際關係，成功協助個案改善操縱行為。護理過程中必須能自我察覺，不陷入自己的負向情緒，這樣的互動過程可使護理人員和病患更了解自己，彼此都能成長，獲得更成熟的人格。

This report described the application of Peplau’s theory in the nursing care of the patient with manipulative behavior. Peplau’s theory contains four different phases: orientation, identification, exploitation, and resolution. This theory helped nurses understand that the patient’s characteristics, such as suspicious to others, insecurity, fear of the intimate relationship, and anxiety. The nurse used therapeutic interpersonal relationship to change the patient’s attitudes and manipulative behaviors. During this process, the nurse needed to be aware of controlling his own negative emotions, so that both the patient and the nurse were able to get growth.