應用創傷知情照護於經歷童年創傷的思覺失調症病人之照護經驗

Application of Trauma-Informed Care in a Patient With Schizophrenia and Childhood Trauma

本文旨在闡述創傷知情照護（trauma-informed care）於一位有童年創傷史之男性思覺失調症病人的應用。本文引用美國藥物濫用暨心理健康服務局的理論框架，將其「4R」核心認知轉化為五大核心原則（安全、信任、合作、增能、選擇）作為護理過程的結構性指引。於2025年7月14日至8月7日護理期間，介入措施聚焦於建立心理與情感安全、共同調節創傷反應，並發展個人化之情緒應對策略。成效指標包括：個案的攻擊行為顯著減少、能主動辨識並口頭表達創傷觸發因子，並運用至少三種「接地技巧」（grounding technique）穩定情緒。本案例證實，將創傷知情照護理論結構化地應用於護理過程，能有效提升個案的自我效能及護病合作關係，為處理複雜創傷合併精神症狀之個案提供了具參考價值的照護模式。

This article presents a case study on the application of trauma-informed care on a male patient with schizophrenia and a history of childhood trauma. The nursing process was designed using the Substance Abuse and Mental Health Services Administration framework. For this case study, the“4R”core assumptions were transposed into five actionable principles (safety, trustworthiness, collaboration, empowerment, and choice), which guided all of the provided interventions. From July 14 to August 7, 2025, the nursing care focused on promoting psychological and emotional safety, facilitating the co-regulation of trauma responses, and fostering the development of personalized emotional coping strategies. All of the key outcome measures demonstrated significant improvement, with the patient showing a marked decrease in aggressive behaviors, the development of the ability to identify and articulate trauma triggers, and the ability to successfully use at least three distinct grounding techniques for emotional stabilization. This case confirms that applying trauma-informed care theory in a structured manner can effectively improve patient self-efficacy and strengthen the nurse-patient collaborative relationship. The findings provide a valuable, evidence-informed care model for managing the complexities of co-occurring psychiatric symptoms and trauma.