一位青少年躁症患者及其家庭之護理經驗

The Experience of Nursing Care for an Adolescent Patient with Manic Disorder and His Family

本文在探討一位曾吸食安非他命併有躁症之青少年，因其敏感性體質，屢次對治療用藥過敏而停藥，使其精神症狀及干擾行為無法改善，於護理過程中採用羅氏適應模式進行護理評估，發現其有高危險性暴力、思想過程改變、社交互動障礙、個人因應能力失調及家庭運作過程改變等十項護理問題。在護理過程中，協助促進個案身體舒適、引導衝動控制、教導合宜的異性交往技巧、提供正確的電痙治療訊息，使其舒適情形改善、暴力行為明顯減少、人際互動增加；案父母亦經給予支持，教導疾病相關認知及照護技巧後，情緒得到宣洩，家庭結構功能得以恢復正常運作，對照顧個案不再擔心，幾經討論後同意將個案轉介至日間留院繼續接受精神復健。

The purpose of this article was to discuss an adolescent manic disorder patient treated with amphetamine. The patient had to stop medication due to his sensitive physique. According to Roy's Model assessment, we found the patient to have ten nursing problems, including high risk violence, altered thought processes, impaired social interaction, and altered family processes, et cetera. In the process of nursing, by improving physical comfort level of the patient, leading good impulse control, teaching accurate interpersonal skills and providing correct information about electroconvulsive therapy, the patient had significant improvement mentally and physically, including decrease of violent actions, upgrade of comfort level and improvement in interpersonal skills. In the process, the patient's parents also provided appropriate care and support. As a result, not only the patient's health improved, but also the family functioned well again. Presently, the patient has been transferred to day care ward.