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題名:一位憂鬱症病患的護理:著重應用認知治療
書刊名:中華心理衛生學刊
作者:吳珮君陳杏佳
作者(外文):Wu, Pei-guinChen, Shing-chia
出版日期:2004
卷期:17:2
頁次:頁93-111
主題關鍵詞:憂鬱症認知治療護理DepressionCognitive therapyNursing care
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(6) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:6
  • 共同引用共同引用:10
  • 點閱點閱:38
本個案報告乃著重應用認知治療於照顧一位女性憂鬱症病患的護理經驗,在病患住院四週的護理過程中,經評估後,發現個案的護理問題包括因應能力失調、睡眠型態紊亂、舒適情況變差、潛在危險性暴力朝向自己,而其核心為涉及不良功能的認知問題,故在一般護理措施之外,採Beck理論所發展的不良功能認知表格為特殊護理之措施,以修正個案之認知,並提升其正向情緒。結果發現與個案不良功能認知有關的情境類型包括角色完成、精神疾病與人際互動。其中,認知扭曲的類型包括負面預期、過度類化、擴大與縮小及情緒推理,核心問題的信念如負責、希望被喜愛,及精神疾病社會烙印。修正經由認知扭曲所產生的自動化思考後,個案情緒部分改善最多為女兒角色完成,最少為疾病的自我概念,認知部分改善最多為工作角色完成,最少為失眠。此外,病患出院後二週內,予電話追蹤,發現亦可恢復其對壓力事件的控制感,有適切的反應及提升出院後的因應能力。文中提出臨床經驗與建議,期待對未來類似憂鬱症病患護理有所助益。
This case report was a nursing experience that emphasizing the application of cognitive therapy to care a female depressive patient. During the four weeks of inpatient care, we found her nursing problems included ineffective coping, sleep disturbance, the negative change of comfortable conditions, and the potential risk of violence toward self. The core of the problems was related to her dysfunctional cognition. Therefore, in addition to general nursing intervention, we applied the Beck's cognitive model as a special nursing intervention to modify the case's cognitive thinking, and to improve her mood. The results showed that the three kinds of situations related to dysfunctional cognitive thinking were role performance, mental illness, and personal interaction. Among these situations, the case's negative prediction, overgeneralization, magnification and minimization, and emotional reasoning were presented the process of her automatically cognitive distortion. The beliefs of keeping responsibility, hoping to be loved, and social stigma with mental illness are the critical points. In the aspect of emotion, the outcome of the cognitive therapy showed that her role performance as a daughter improved most, while the self-concept related to disease improved the least. In the aspect of cognition, her role performance as worker improved most, while insomnia improved the least. Moreover, followed up her work conditions for two weeks by five phone calls after her discharge from the hospital, it showed that the case could cope appropriately and restored the ability to deal with the stress in the community as well. In this case report, we shared our nursing care experiences and provoked further suggestions focused on the application cognitive therapy for the patient with depression.
期刊論文
1.劉明倫、陳美如、劉光中(19940700)。憂鬱症的認知治療。國防醫學,19(1),19-21。  延伸查詢new window
2.張艾如、柯慧貞、葉宗烈、陸汝斌(19960300)。簡式認知型態測驗與認知錯誤問卷之信度與效度。中華精神醫學,10(1),36-44。  延伸查詢new window
3.曾美智、李宇宙、李明濱(19990600)。憂鬱症與焦慮症之共患現象。臺灣精神醫學,13(2),37-47。new window  延伸查詢new window
4.余春娣、陳杏佳(2001)。協助一位精神分裂症病患整合自我概念以增進病識感之護理。護理雜誌,48(5),79-86。new window  延伸查詢new window
5.張秀如、蕭淑貞(1995)。運用認知行為治療協助一位失眠症個案的護理過程。護理雜誌,42(1),53-64。  延伸查詢new window
6.鄭韻如、鐘思嘉(1992)。認知行為治療的理論。輔導季刊,28(7/ 8),2-8。  延伸查詢new window
7.鐘思嘉(1992)。認知行為治療的技術。輔導季刊,28(7/ 8),9-15。  延伸查詢new window
8.Hollon, S. D.、Shelton, R. C.、Davis, D. D.(1993)。Cognitive therapy for depression: Conceptual issues and clinical efficacy。Journal of Consulting and Clinical Psychology,2,270-275。  new window
9.Paykel, Eugene S.、Scott, J.、Teasdale, J. D.(1999)。Prevention of relapse in residual depression by cognitive therapy。Archives of General Psychiatry,57(7),827-835。  new window
10.Scott, J.(2001)。Cognitive therapy for depression。British Medical Bulletin,57,101-113。  new window
圖書
1.孔繁鐘、孔繁錦(2000)。DSM-ΙV精神疾病診斷準則手冊。臺北:合記。  延伸查詢new window
2.Beck, J. S.(1995)。Cognitive Therapy: Basics and Beyond。New York, NY:Guilford Press。  new window
3.李引玉(1991)。實用精神科護理。實用精神科護理。臺北。  延伸查詢new window
4.李引玉(1998)。情感障礙病人護理。精神科護理學。臺北。  延伸查詢new window
5.李明濱、黃偉俐(2001)。行為治療與認知治療。實用精神醫學。臺北。  延伸查詢new window
6.黃宗正(2001)。情感疾病。實用精神醫學。臺北。  延伸查詢new window
7.施欣欣(1996)。個別心理治療。精神科護理概論-基本概念與臨床應用。臺北。  延伸查詢new window
8.高紀惠(2000)。新護理診斷手冊。新護理診斷手冊。臺北。  延伸查詢new window
9.Blackburn, I. M.、Davidson, K. M.(1989)。Cognitive therapy for the depression and anxiety - A practitioner's guide。Cognitive therapy for the depression and anxiety - A practitioner's guide。Oxford。  new window
10.Blackburn, I. M.(1992)。Severely depressed in-patients。Cognitive therapy in clinical practice: an illustrative casebook。London, UK。  new window
圖書論文
1.黃珮玲(1998)。自我概念改變病人護理。精神科護理學。台北:華杏。  延伸查詢new window
 
 
 
 
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