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題名:運用結構性家族系統觀點於一位神經性厭食症患者之護理經驗
書刊名:長庚護理
作者:李宜玟
作者(外文):Lee, Yi-wen
出版日期:2017
卷期:28:2=98
頁次:頁346-356
主題關鍵詞:結構性家族系統觀點神經性厭食症Structural family therapyAnorexia nervosa
原始連結:連回原系統網址new window
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  • 共同引用共同引用:1
  • 點閱點閱:2
本文主要為筆者運用結構性家族系統觀點協助一位神經性厭食症患者之護理經驗。護理期間為2014年1月24日至2014年3月7日。藉由觀察、會談及病歷查閱蒐集資料,以五大層面評估,發現主要的護理問題為:營養狀況改變:少於身體所需、家庭因應能力失調、身體心像紊亂、高危險性暴力行為:朝向他人、個人因應能力失調及思考過程改變。筆者整合跨醫療團隊照護意見,與個案及父母親取得治療聯盟,並以結構性家族系統理論,運用重整家庭結構之技巧修正家中不合宜的互動規則、增進家庭成員彼此能彈性轉換系統間的角色,以及建立家庭成員間明確的界限。個案於住院期間體重由25.5公斤上升至30.6公斤,且家族成員間在彼此溝通模式上也有更成熟的因應技巧。希望透過此報告能提供護理人員對神經性厭食症之照護有更深的認識,亦可做為臨床照顧的參考。
This case study reported the nursing care experience of a patient with anorexia nervosa (AN) using the structural family therapy (SFT). The nursing care took place between 24th January and 27th March 2014. Five dimensions of psychiatric nursing evaluation were conducted using clinical observation, psychiatric interview, and medical chart review. The main nursing diagnoses included altered nutrition (less than body requirements), ineffective family coping strategies, attempt to aggressive, disabled personal coping and altered thought processes. The author integrated the opinions of the medical team and formed a working alliance with the patient and her parents. Applying theory of SFT and reforming family structure enabled the patient to (1) modify inappropriate family interaction, (2) improve switching role functions among family members flexibly, and (3) set clear-cut boundaries in family relationships. The patient's body weight had increased from 25.5 kg to 30.6kg during the hospitalization period. In addition, smooth unhindered communication among family members became available after acquiring more mature coping skills. This report provided a better understanding of AN and might serve as a reference for nursing staff while taking care of patients with AN in the future.
期刊論文
1.林祥源、曾美智(20110900)。Inpatient Treatment of Anorexia Nervosa and Refeeding Syndrome。臺灣精神醫學,25(3),126-139+222。new window  延伸查詢new window
2.Tsai, M.-R.、Chang, Y.-J.、Lien, P.-J.、Wong, Y.(2011)。Survey on eating disorders related thoughts, behaviors and dietary intake in female junior high school students in Taiwan。Asia Pacific Journal of Clinical Nutrition,20(2),196-205。  new window
3.胡雯雯、莊麗玉(20141000)。運用結構性家族系統觀點於一位強迫症患者之護理經驗。精神衛生護理雜誌,9(1),30-40。  延伸查詢new window
4.洪佳慈(20120700)。心因性厭食症之家族治療。諮商與輔導,319,29-32。  延伸查詢new window
5.何怡穎(20081000)。結構派家族治療理論在親職教育上的應用。諮商與輔導,274,31-34+6。  延伸查詢new window
6.林荷芳(20101200)。厭食症的診斷與治療。諮商與輔導,300,20-25。  延伸查詢new window
7.洪家榮(2009)。從結構派家族治療理論分析自我家人互動關係。家庭教育雙月刊,19,60-67。  延伸查詢new window
8.陳雅郁(20091200)。一位神經性厭食症病患之護理經驗。精神衛生護理雜誌,4(2),66-73。  延伸查詢new window
9.陳沛瀅、卓妙縈(20120200)。厭食症的家族治療--從結構取向出發。諮商與輔導,314,11-15。  延伸查詢new window
10.張家禎、鄒孟婷、陳薇光、張倍禎(20120900)。厭食症淺介。家庭醫學與基層醫療,27(9),314-318。  延伸查詢new window
11.Fishman, H. C.(2006)。Juvenile anorexia nervosa: Family therapy's natural niche。Journal of Marital and Family Therapy,32(4),505-514。  new window
圖書
1.Minuchin, S.、Lee, W. Y.、Simon, G. M.、劉瓊瑛、黃漢耀(2003)。學習家族治療:家族治療師的成長與轉化之旅。台北市:心靈工坊文化。  延伸查詢new window
2.Minuchin, S.、Rosman, B. J.、Baker, L.、李淑珺(2009)。厭食家族:探索心身症的家庭脈絡。台北市:心靈工坊文化。  延伸查詢new window
3.Minuchin, S.、劉瓊瑛(2007)。結構派家族治療入門。臺北市:心理出版社。  延伸查詢new window
4.American Psychiatric Association(2013)。DSM-V: Diagnosis and statistical manual of mental disorders。Washington, DC:American Psychiatric Association。  new window
 
 
 
 
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