一位甲狀腺毒症患者術後合併精神症狀之護理經驗

Nursing Experience in a Patient of Thyrotoxicosis after Surgery Combining With Psychotic Symptoms

本文探討一位甲狀腺毒症的個案，於突眼症開刀術後產生精神症狀的護理經驗。以五大層面評估為指引，藉由觀察、會談及直接護理，確立的問題包括：感覺知覺改變、思想過程改變以及知識缺失。護理過程中，與個案及家屬建立信賴的治療性關係；教導幻覺、妄想與現實的區辨及自助調適技巧；建立疾病認知及加強規則服藥的重要性，最後個案能自我控制精神症狀，避免干擾他人而與症狀和平共存，也願意規則服藥及定時返診。家屬能了解甲狀腺問題及精神疾病之概念，並願意監督個案服藥，以促進適應疾病生活。藉此經驗有助於臨床護理人員更加了解合併有甲狀腺問題之精神症狀患者的照護。

The purpose of this article was to describe nursing experience in a patient with thyrotoxicosis, whodeveloped the psychotic symptoms after the operation for ophthalmopathy. The authors collected data,using conversation, observation, direct nursing care, and holistic nursing assessments.Then they identifiedthe patient's problems as follows: altered thought processes, sensor/perceptual alteration, and knowledgedeficit.During the nursing process, the authors established a rapportwith the patient and family, in discriminatinghallucinations, and delusions fromreality and fostering the skills of self-management.Finally, the patientcould have better coping skillswith psychotic symptoms, coexistwith the symptoms peacefully, takemedicine, and return for outpatient services regularly.Finally, the family could have better understanding ofthe disease concept, acceptmental illness andmonitor the patient's drug compliance.This study should behelpful for us in understanding howto care for the patient of psychotic disorder combiningwith a thyroidproblem.