運用放鬆技巧及生理回饋訓練照顧門診一憂鬱症患者身心症狀之護理經驗

The Application of Relaxation Techniques and Biofeedback to an Outpatient with Depression Disorder: A Nurse's Experience

本文描述協助一位於精神科門診之憂鬱症患者改善其身心症狀之護理經驗，護理期間為97年4月10日至7月24日，個案除憂鬱症診斷外，還包括長期的緊繃及疼痛問題，筆者以整體性護理評估，藉由觀察及會談方式來收集資料、確立問題，發現個案有：個人因應能力失調、慢性疼痛及睡眠形態紊亂等問題，運用放鬆及生理回饋訓練為護理照護主軸，針對個案問題與其進行討論後擬定放鬆及生理回饋訓練療程與護理照顧計劃，共進行8次，每次45-60分鐘，內容包括晤談、放鬆技巧（漸進式肌肉放鬆、冥想式放鬆、靜坐、音樂及腹式呼吸等），以及透過生理回饋儀器之指溫偵測器做視覺回饋。個案有明顯的改變動機並積極參與治療計劃，逐漸能夠覺察放鬆的內在感覺及身心症狀的心理病源性，並學習到在生活壓力情境中也能掌控身體放鬆的要訣。療程結束時個案自我放鬆控制有明顯提升、護理問題獲得改善，也能逐漸將放鬆的感覺內化到生活當中。

This paper reports on a nurse's experience helping alleviate psychosomatic symptoms in a psychiatric outpatient suffering from depression. It was found that the OPD patient had been suffering from depression as well as long-time tension and pain. Between April 10th and July 24th, 2008, the author employed holistic nursing assessment and collected data through both observation and interview. Three major care problems were identified, including ineffective individual coping, chronic pain, and sleep disturbance. Focusing nursing care on relaxation techniques and biofeedback, the author discussed the problems with the patient and then implemented relaxation training and biofeedback training sessions as well as nursing care plans, which averaged 45~60 minutes per time for 8 times. Sessions included interviews, relaxation techniques (e.g., progressive muscular relaxation, meditative relaxation, meditation, music and abdominal breathing) and visual feedback measured by a biofeedback device with a thermistor sensor. During sessions, the patient was clearly motivated to change and participated actively. Furthermore, the patient not only became gradually aware of both the inner feeling of relaxation and etiology of psychosomatic symptoms, but also learned relaxation strategies for coping with life stressors. After therapy, the patient's self-control over relaxation had improved considerably and care problems were resolved satisfactorily. Also, the patient could increasingly incorporate relaxation into daily life routines.