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題名:以結合輔具的溝通方式降低額顳葉失智症病人躁動之護理經驗
書刊名:護理雜誌
作者:施盈君王雅慧楊詠仁
作者(外文):Shih, Ying-jyunWang, Ya-huiYang, Yung-jen
出版日期:2014
卷期:61:6
頁次:頁98-103
主題關鍵詞:額顳葉失智症溝通障礙躁動行為Frontotemporal dementiaCommunicative impairmentAggression
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
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  • 共同引用共同引用:5
  • 點閱點閱:30
本文是照顧一位溝通表達障礙的額顳葉失智症病人之護理經驗。個案因罹患額顳葉失智症,出現語言表達障礙,並因躁動行為,致照顧負荷沈重而入精神科急性病房接受治療。護理期間為2012年3月5日至2012年4月30日。筆者運用五大層面整體性指引與相關量表進行評估,發現三個主要健康問題:言辭溝通障礙、慢性混亂、照顧者角色緊張。本報告中之護理過程,主要著眼於個案的言辭溝通障礙問題。筆者運用溝通輔具結合溝通策略,設計適合個案的溝通模式,以促進表達及溝通,進而改善躁動行為;並將此溝通模式教導給家屬,藉此提升照護能力且緩解負荷。建議於照護額顳葉失智併溝通障礙病人時,可參考本報告經驗,將溝通輔具運用於溝通策略之中,設計合適的溝通模式,以提升照護品質。
This report introduces the nursing caring experience with a male patient with frontotemporal dementia (FTD) who was hospitalized in an acute psychiatric ward from March 5th to April 30th, 2012 due to the clinical manifestations of verbally expressive impairment, aggression, and subsequent caregiver burden. The patient was assessed according to the guidelines of clinical competencies for mental health nursing assessments developed by the Psychiatric Mental Health Nurses Association. Three clinical diagnoses were identified after this assessment, including (1) impaired verbal communication, (2) chronic confusion, and (3) caregiver role strain. The current report focuses only on the clinical issue of impaired verbal communication. We adopted a props-integrated communicative approach by integrating props and physical motions with communicative strategies. This approach enabled us to formulate a patient-centered communicating model and prompt for active expression and adequate communication, which ultimately resolved the patient's aggression problem. In addition, we provided psychoeducation to the family members in order to teach them the relevant knowledge, skills, and approaches that caregivers may use to enhance their caring capabilities and reduce the burden of caregiving. This successful experience may be used as a reference in caring for FTD patients with communicative impairments. Our proposed approach integrates props with simple language and develops an appropriate communicating model to provide high quality care for patients.
期刊論文
1.Cohen-Mansfield, J.、Marx, M. S.、Rosenthal, A. S.(1989)。A description of agitation in a nursing home。The Journal of Gerontology: Medical Sciences,44(3),M77-M84。  new window
2.Jootun, D.、McGhee, G.(2011)。Effective communication with people who have dementia。Nursing Standard,25(25),40-46。  new window
3.王靜枝、胡嘉容、張文芸(20110200)。與失智患者之有效溝通策略及方法。護理雜誌,58(1),85-90。new window  延伸查詢new window
4.Beukelman, D. R.、Fager, S.、Ball, L.、Dietz, A.(2007)。AAC for adults with acquired neurological conditions: A review。Augmentative and Alternative Communication,23(3),230-242。  new window
5.Bourgeois, M.、Fried-Oken, M.、Rowland, C.(2010)。AAC strategies and tools for persons with dementia。The ASHA Leader,15(3),8-11。  new window
6.Dettmore, D.、Kolanowski, A.、Boustani, M.(2009)。Aggression in persons with dementia: Use of nursing theory to guide clinical practice。Geriatric Nursing,30(1),8-17。  new window
7.Fried-Oken, M.、Rowland, C.、Daniels, D.、Dixon, M.、Fuller, B.、Mills, C.、Oken, B.(2012)。AAC to support conversation in persons with moderate Alzheimer’s disease。Augmentative and Alternative Communicationy,28(4),219-231。  new window
8.McKay, H.、Hanzaker, M.(2013)。Dementia care communication: A toolbox for professionals and families。OT Practice,18(2),CE-l-CE-8。  new window
9.Rascovsky, K.、Hodges, J. R.、Knopman, D.、Mendez, M. F.、Kramer, J. H.、Neuhaus, J.、Miller, B. L.(2011)。Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia。Brain,134(9),2456-2477。  new window
10.Riedijk, S. R.、de Vugt, M. E.、Duivenvoorden, H. J.、Niermeijer, M. F.、van Swieten, J. C.、Verhey, F. R. J.、Tibben, A.(2006)。Caregiver burden, health-related quality of life and coping in dementia caregivers: A comparison of frontotemporal dementia and Alzheimer’s disease。Dementia and Geriatric Cognitive Disordersy,22(5/6),405-412。  new window
11.Warren, J. D.、Rohrer, J. D.、Rossor, M. N.(2013)。Clinical review. Frontotemporal dementia。BMJ,347,4827。  new window
12.Algase, D. L.、Beck, C.、Kolanowski, A.、Whall, A.、Berent, S.、Richards, K.、Beattie, E.(1996)。Need-driven dementiacompromised behavior: An alternative view of disruptive behavior。American Journal of Alzheimer’s Disease and Other Dementias,11(6),10-19。  new window
13.Cohen-Mansfield, J.、Billig, N.(1986)。Agitated Behaviors in the Elderly: I. A Conceptual Review。Journal of the American Geriatrics Society,34(10),711-721。  new window
研究報告
1.邱銘章、王培寧、孫瑜、傅中玲、陳達夫、林克能、花茂棽、白明奇、黃正平、湯麗玉、林仲志(2013)。失智症 (含輕度認知功能障礙 mild cognitive impairment, MCI) 流行病學調查及失智症照護研究計畫 (計畫編號:DOH102-TD-M-113-100001)。台灣失智症協會。  延伸查詢new window
其他
1.The Association for Frontotemporal Degeneration(2012)。Partners in FTD care,http://www.theaftd.org/wp-content/uploads/2011/09/January-2012.pdf。  new window
 
 
 
 
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