一位慢性精神分裂病人之行為修正與護理過程應用

Implication of Behavior Modification and Nursing Process for a Schizophrenic Patient—A Case Study--

採用行為修正理論，設計一套行為修正計畫，矯正一位日間留院慢性精神分裂症患者之干擾行為，並教導、改善其自我照顧能力。此治療方案由護士主導，配合護理過程運用及家屬的協助，以鼓勵及代幣制度來幫助個案。經過一年的治療，病人的重覆洗手、洗澡、反覆更衣、擅取母親衣服穿用、半夜起來吵父母、四處亂丟衣物等不良行為皆獲得明顯改善，責任感及參與工作的意願增強。治療過程中個案家庭親子關係亦得以增進；結果評價，顯示精神科護理人員可藉由行為修正，矯正病人干擾行為及提升病人的自我照顧能力。

In nursing practice. A behavior modification program was used to correct the disturbing behavior and improve the self care ability of a 31-year-old schizophrenic patient in psychiatric day ward. The program was designed by a psychiatric nurse. Praise and token economy system were used to reduce frequency of the patient’s inappropriate behaviors, such as repeated hand-washing, bathing, and bother her parents at midnight. After 52-week’s treatment course, the frequency and intensity of the patient’s disturbing behaviors were reduced; her responsibility and motivation to work were enhanced; and communication between the patient and her family was improved. The result showed that nursing staff in psychiatric hospitals can facilitate healthy behaviors in schizophrenic patients through the use of behavior modification as a form of nursing intervention.