PDF《一位自杀未遂个案之护理经验》

7 【摘要】本篇为照顾一位自杀未遂个案之护理经验,经由直接观察、会谈、身体评估等方式取得资料,运用罗氏适应模式评估,确立健康 问题有「无效性因应能力」、「急性疼痛」及「身体活动功能障碍」,在护理过程中运用关怀、倾及同理心了解个案负向思考,从中建 立良好护病关系.

引导家庭成员与病患间距离,表达自我感受及增强自我因应能力 ;

透过药物与另类疗法来缓解个案的疼痛 ;

依病程进展 维持肌肉强度和关节活动及复健护理,促进个案的独立程度.经由医疗团的治疗及护理措施的执行,解决住院期间的不适以及积极学习 后续照护方法,个案表示日后面对压力冲突事件会采取正向的应变措施,出院后能维持自我照顾能力. 【关键词】 护理照护 自杀 自杀未遂 The nursing experience of a suicide attempts patient Yue Kuo Liu1* Li Chueh Weng2 [Abstract] This case report described the nursing experience of a suicide attempts patient. Using the Roy'

s Adaptation model as a framework, we assessed patient by observation, interview and physical assessment. The major health problems of this patient were coping ine?ective, acute pain, and impaired physical function etc. Therefore, authors established therapeutically relationship with the patient through caring, empathy, and listening. In addition, we encouraged family members to establish a good patient-family relationship and provided the opportunity for patient to express the negative emotion and enhance coping ability. We also provided medication and alternative therapy for pain control, physical rehabilitation for maintaining muscle strength and joint activity. After the individualized and appropriate nursing interventions, patient'

s distress symptom and self-care ability were improved gradually. Patient reported that he had the con?dence and would adopt the positive coping strategies to deal with his disability, stress, and con?icts in the future. [Key Words] nursing care suicide suicide attempts 个案护理 Nursing Case Study 一位自杀未遂个案之护理经验 刘岳帼 1* 翁丽雀

2 * 通讯作者 Corresponding author:[email protected]

1 财团法人恩主公医院胸腔外科 Thoracic Surgery, En Chu Kong Hospital

2 长庚大学护理系 Chang Gung University School of Nursing Received date:26 May

2017 Accepted date:27 September

2017 doi:10.6729/MJN.2017.002 1. 前言 世界卫生组织估计全世界每年有超过

80 万人死 於自杀 (WHO,2014).在台湾地区,自杀死亡约占 死亡人数的 2%,自杀问题已连续八年名列本国十大 死亡之一,且自杀人口以

25 岁到

65 岁之青壮男性为 主(李明滨,2011).具自杀意图者 (suicide attempter) 是自杀死亡者的 10-20 倍(苏宗伟、李明滨,2006;

南玉芳,2011),显示自杀问题是值得重视的问题. 本文的个案因窃盗罪入狱服刑后自杀,重伤导致 左手活动功能障碍,而入住医院接受照护.受刑人 监禁之压力来自於人身自由被剥削、身分被贬、监 禁硬体设施与管理方式等,学者指出,受刑人会迫 於监狱环境压力而选择自杀 ( 台湾自杀防治学会, 2011).受刑人因其身分特殊,处於人际疏离及缺 乏社会支持,选择以自杀方式对应压力及逃避现实, 故引发笔者的照护动机.期望运用护理过程给予个 案寻求协助,增强社会支持力量并共同解决生理障 碍,使其能够健康地重返社会,减少后续可能造成 的伤害和遗憾,并提出照护经验以供参考.