照顧一位憂鬱症併有自殺企圖患者之護理經驗

Experience Caring for a Depression Patient Who Had Attempted Suicide

本文描述照護一位憂鬱症病患，因憂鬱、負向思考而反覆出現企圖自殺之護理經驗。護理期間自97年4月18日至97年6月7日。利用貝克氏憂鬱量表和精神科五大層面進行整體評估，發現主要問題為潛在危險性自殺、失眠、營養不均衡－多於身體需要、長期性低自尊及無效性因應能力。筆者運用治療性溝通技巧，以傾聽、同理態度來照顧個案；針對個案問題導因來協助病患面對問題。另在護理照護期間，觀察個案對生活壓力處理較消極，反覆以自傷方式處理自己的情緒；透過多次會談修正其負向思考，減少了個案自殺的想法。願藉由此經驗分享，提供臨床人員在照顧此類個案之參考。

This paper addresses the experience of caring for a depression patient who had repeatedly attempted suicide because of his depression and negative thoughts. The period of providing nursing care for this patient was from April 18(superscript th) to June 7(superscript th), 2008. The 'Beck depression inventory' scale and five facets of psychiatry assessment were applied in order to obtain a comprehensive assessment of the patient. Five major issues or problems were identified: the potential risk of suicide, insomnia, unbalanced nutrition associated with a food intake greater than their physical need, long-term low-esteem, and inefficient coping. Therapeutic communication skills with empathy and a non-judgmental attitude were applied when caring for the patient. Focusing on the causes of problems, the patient was guided through how to deal with the problems. During the process of nursing, it was found that the patient was employing a negative attitude when dealing with life pressures and repeatedly injured himself as he faced his own feelings. Several interviews were employed to adjust his negative way of thinking and to reduce his suicidal thoughts. This case report provides reference experiences that should help nursing personnel with similar cases.