照護一位服用抗精神病藥物致體重過重患者之護理經驗

A Nursing Experience in a Patient with Antipsychotics-Induced Overweight

本文描述照護一位因服用抗精神病藥物致體重過重之精神分裂症患者的護理經驗，護理期間為93年5月1日至93年6月10日，筆者以整體性護理評估為指引，並藉由觀察及會談方式來收集資料，發現個案有：（1）感覺及知覺紊亂、（2）營養不均衡：多於身體需要、（3）無效性健康維護能力三個護理問題。護理人員經治療性人際關係的建立，教導有效處理幻聽干擾之技巧與提供個別性的減重計畫，不但使個案於住院期間受幻聽干擾頻率減少、減輕體重5.5公斤，並且讓個案能修正對疾病與藥物的錯誤信念。因此，筆者建議精神科護理人員可以運用個別性減重計畫來協助病人改善因為使用第二代抗精神病藥物所產生之體重過重情形，讓病人能以正向的態度來面對疾病，改善服藥順從性，提升自我健康維護能力。

The purpose of this article is to describe a nursing experience with a patient with schizophrenia who had antipsychotics-induced overweight. The authors assessed the patient's health condition and provided weight management to reduce her hallucinations as well as her body weight between May 1 and June 10, 2004. Three nursing problems had been identified as follows: disturbed sensory perception, imbalanced nutrition, and ineffective health maintenance. During the nursing process, the authors established a rapport relationship with the patient and her mother, educated them in skills for reducing hallucinations, and designed an individual body weight management program. After the interventions, the patient was able to positively face her illness, effectively use methods to reduce the impact of hallucinations, and successfully lose 5.5kg. From this perspective, an individual body weight management program can be an effective intervention for nurses to care for this group of patients.