協助一位慢性精神分裂症病患回歸社區生活之護理經驗

The Nursing Experience of Helping a Patient with Chronic Schizophrenia to Rctum the Community

本篇描述一位重複發病的慢性精神分裂症患者，因財務問題與家人關係冷淡，導致家人對其住院精神醫療與日常生活不加理會，最後致使個案經濟生活陷入困頓。本文藉由社區精神復建為照護基礎，協助個案逐日回歸社區生活的照護經驗。護理期間為95年8月3日至96年7月31日，筆者運用全人照顧理論概念，以會談、觀察、身體評估與查閱病歷等方式收集資料，確認個案有健康維護能力改變∕缺乏有關精神疾病及治療知識，個人因應能力失調∕情境性危機－家庭支持系統不足，無望感∕長期壓力、被遺棄，自尊紊亂∕長期性低自尊等護理問題。藉由協助個案對疾病的認識，增加其對治療的遵從度，並透過社會技能訓練的介入，協助零用金與日常生活的規劃，同時經由參與病房團體活動、院內工作訓練和連結社會資源，使個案獲得自我照顧能力及生活決定權，並能持續一年於社區中自給自足的獨立生活，重新找回自信和建立新的社會支持系統。The purpose of this article was to help the patient with chronic schizophrenia in the event of the recurrence of the illness, who was deeply frustrated with life's events and family relationship difficulties, after leaving the family-oforigin to increase self-reliance ability from the nursing care experience. The care service was provided from August 3, 2006 to July 31, 2007. The writer adopted a holistic care theories assessment tool to interview, observe, do physical assessment and access to medical records to collect the information. The nursing problem of the psychiatric patient consisted of altered health maintenance, ineffective individual coping, hopelessness, self-concept disorders, and low chronic self-esteem. The patient was individually given information about understanding the disease, increasing treatment compliance with instructions in nursing related knowledge, and through the utilization of social resources to assist in the planning of money and daily life, through group activities and with the participating hospital wards that provide training, so that the client will be independent in community life, getting self-confidence back and the establishment of a new social support system.