運用習慣反向治療於妥瑞症病人之護理經驗

Nursing Experience of Using Habit Reversal Therapy in a Patient with Tourette's Disorder

本文係說明照護一位20歲男性妥瑞症病人之護理經驗，因嚴重自我傷害行為入院求治，於住院期間，筆者藉會談及觀察技巧來收集資料，並運用Gordon’s十一項功能性健康型態評估，發現病人有：高危險性自傷、個人因應能力失調、家屬缺乏應付能力、現存性損傷、自我照顧能力不足等健康問題，在護理過程中除建立良好的護病關係，提供病人及家屬相關疾病護理指導、心理支持外，運用習慣反向治療(habit resersal therapy,HRT)實際引導病人及家屬參與，最後病人的自傷行為明顯改善，重新回復自信而順利出院返家。

This article presented the nursing experience of taking care of a twenty-year-old young manwith Tourette's disorder who was admitted due to severe self-injuring behaviors. During thehospitalization, the authors collected data based on conference and skills of observation and usingGordon's 11 Functional Health Patterns to delineate the patient's health problems including highdangerous self-injury, dysfunction of self-response, absence of capability of his family members'management, and existing damage and inability to take care of himself. The authors established agood nurse-patient rapport during the nursing care.We provided the patient and his family memberswith relevant nursing guidance in addition to emotional support. We also applied Habit ReversalTherapy (HRT) involving the patient and his family members, which resulted in improvement of thepatient's self-injuring behaviors and establishment of his self-confidence. The patient was thensmoothly discharged back home.