照護一位躁鬱症且有強烈自殺企圖病人之護理經驗

A Nursing Experience of a Bipolar Patient with Suicidal Tendency

本篇是描述一位躁鬱症的女性病人，於住院期間有自殺未遂的照護經驗。照護期間為2014年7月2日~2014年8月15日，藉由實際觀察、會談、病歷回溯及整體性護理評估收集資料，歸納出個案主要健康問題：現存危險性暴力行為：自我傷害、社會互動障礙、個人因應能力失調、身體心像改變，透過與個案建立治療性人際關係，利用情緒評估量表教導個案自我覺察情緒變化，運用復原力不斷協助個案覺察、發揮自身的能力及可運用的資源，喚起其潛在的能量，恢復其能維持家庭生活功能及社會人際互動的自信，並協助住院期間未再有傷害發生。期望能分享從正向、資源的角度出發，協助個案覺察本身已存在的復原力、強化正向發展，避免病人反覆自殺之護理經驗。

This article described a nursing experience of a female patient with bipolar disorder who had made a failed suicide attempt during hospitalization. The nursing duration lasted from July 2nd to August 15th, 2014. Information were collected by trained observations, conversations, medical records reviews, and comprehensive nursing assessments, the following main health issues were identified: existing dangerous violent and self-injurious behaviors, impairment in social reciprocity, ineffective individual coping, and body image changes. By building a therapeutic relationship with the patient, the author educate the patient to identify emotional changes through emotional assessment scale. And by using resilience, the author to assist the patient in identifying and utilizing her own strength and available resources to conjure her potential energy, which in turn sustained her function of family life, restored her confidence in social interactions, and prevented self-injurious behaviors from occurring during hospitalization. This sharing provided a nursing example that, by assisting the suicidal patient to identify her inherent resilience to enhance positive growth, the occurrence of further self-injurious behaviors were prevented.