COVID-19疫情威脅下之精神科居家照護服務

Psychiatric Home Care Nursing Services under The Threat of COVID-19 Epidemic

嚴重特殊傳染性肺炎(coronavirus disease, COVID-19)自2019年爆發，對公共衛生造成了極大的威脅，精神科居家照護除了面臨居家訪視過程進入社區面對疫情交互傳染的風險外，在面對精神病人的同時，如何提供持續且全方位的精神與防疫照護，變成精神居家照護的一大挑戰。本文除了說明感染管制措施在居家訪視過程中的運用外，亦用公衛四段七級的概念來加強疫情期間整體居家照護的任務，結果顯示在防疫管控措施下，精神居家的再住院率未大幅上升。經過這次面對COVID-19疫情的處理經驗，深刻體認面對精神病人，除了生理狀況需要照護外，病患及家屬的心理需求、防疫措施的協助等，也都是臨床醫護人員需要去考量的，未來可能面對後續的新興傳染病，期許防疫工作能謹記──從「心」做起。

Since 2019, the outbreak of Coronavirus Disease (COVID-19) has posed a considerable threat to public health. In addition to the risk of infection during home visits and exposure to community transmission, providing comprehensive care to psychiatric patients has become a major challenge for home psychiatric care. This article not only explains the use of infection control measures during home visits but also uses the four stages and seven levels of public health to strengthen the overall home care mission during the epidemic. The results show that under epidemic prevention and control measures, the readmission rate for home psychiatric care has not increased substantially. Throughout the COVID-19 epidemic, it has become apparent that in addition to caring for patients’physical conditions, clinical medical staff also need to consider patients’and their families’psychological needs and assistance with epidemic prevention measures. In the future, when facing new emerging infectious diseases, it is hoped that epidemic prevention work can begin from the“heart”.