運用社交互動訓練於精神分裂症病患之護理經驗

A Nursing Experience of Applying Social Skill Training to a Patient with Schizophrenia

本文主要描述運用社交訓練改善一位精神分裂症病患因功能退化導致人際社交互動障礙之護理經驗。護理期間為95年8月29日至95年10月7日，筆者藉由五大層面的整體性護理評估，發現個案有：思考過程變異及社交互動障礙的護理問題。筆者首先與個案建立良好的護病關係，以講解、示範、角色扮演、回饋與增強及作業練習的原則，及搭配「社交技巧缺失紀錄表」使用，循序漸進鼓勵及訓練個案學習社交互動技巧。結果發現，個案社交互動技巧進步，也改善因疾病引發的不當人際關係、退化行為、並對自我有了正向的評價。由此得知，精神分裂症患者的社交互動技巧是可訓練改善，期盼以此護理經驗能作為未來精神醫療人員在照護精神病患的參考。

The nursing care experience to improve social interaction function for a patient with schizophrenia is reported in this case study. The researcher used five levels of total nursing assessment to assess a patient, and discovered 2 major nursing problems (thought disturbance and impaired social interactions). The researchers first established rapport with the patient. Then, a framework consists of instructions, coaching, role-playing, demonstrations, practice and homework assignments, was used for the social skill training program. Meanwhile, a social deficit record was kept to document the progress. The care improvement was shown by improved social functioning, modifications of inappropriate interpersonal relationship and regressive behaviors, and establishment of positive self-view. This case report provides evidence that social skills training is effective in improving social skills function for patient with schizophrenia.