一位精神分裂症個案服用非典型抗精神病藥物之護理經驗

Experience Nursing a Schizophrenic Patient Taking Atypical Antipsychotic Drug

本文描述一位精神分裂症患者急性期住院期間，服用非典型抗精神病藥物，造成強烈副作用。經整體性護理評估，發現個案有呼吸道清除功能失效、感覺知覺改變、思考過程改變、睡眠型態紊亂、知識缺失等五項護理問題。在照護期間，除觀察其症狀變化、藥物反應及副作用，並針對藥物副作用處理、症狀處理技巧、藥物衛教等，提供護理指導。症狀穩定後，加強病識感促進持續治療之意願，於出院前幻覺及夜眠問題獲得改善，提升對藥物副作用之處理能力、對疾病的認知增加。藉此護理經驗印證了照護精神分裂症個案，應重視服藥副作用所導致之護理問題，且提供個別及人性化之護理措施，進而減少疾病再復發及回歸社會之可行性。

This article demonstrates strong side effects experienced by a schizophrenic patient who took atypical antipsychotic drugs during her hospitalization. An overall nursing evaluation revealed the patient had five nursing problems, including ineffective clearing of the respiratory tract, sensory and perceptual alterations, altered thought processes, sleep pattern disturbances and knowledge deficits. During the nursing period, we observed changes of symptoms, responses to drugs and side effects. We also taught the patient how to manage her symptoms, helped her to cope with drug side effects, offered education about drugs, and promoted insight into the disease. Hallucinations and insomnia improved before she was discharged. In addition, she knew how to cope with the side effects of the drugs and her cognitive awareness of the disease was also increased. This nursing experience suggests we should emphasize nursing problems caused by side effects of drugs and provide individualized nursing programs to reduce relapses and enhance the feasibility of returning patients to society.