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[一位伴有精神痛苦的边缘型人格障碍患者的护理经历]

[Nursing care experiences of a borderline personality patient with spiritual distress].

作者信息

Liu Chih-Ju, Fang Chun-Kai, Gau Meei-Ling

机构信息

Psychiatric Unit, Mackay Memorial Hospital, Taipei, Taiwan; and Graduate Institute of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.

出版信息

Hu Li Za Zhi. 2011 Dec;58(6):112-8.

PMID:22113642
Abstract

Patients with Borderline Personality Disorder (BPD) often question the purpose and value of their life. Understanding the spiritual needs of BPD patients is essential to providing more appropriate care and achieving greater care efficacy. This case report investigated a woman with BPD who had experienced spiritual distress during nursing care. Between February 24th and December 15th, 2010, the authors conducted an assessment of the four dimensions of spiritual care for the patient using observation, interviews and patient medical records. The four dimensions included the relations between the individual and herself, others, religious belief, and the natural environment. After integrating and analyzing data, the authors found the patient questioned the purpose and value of her life and contemplated self-injury / suicide due to inadequate support systems and a lack of effective stress management and coping skills caused by illness-induced depression and the lingering effects of a difficult childhood. In the process of nursing care, the authors employed one-to-one interviews with listening skills to induce the patient to describe her spiritual distress, and then employed dialectical behavior therapy groups and education skills training to enhance the values of positive thinking and reduce suicidal / self-injury tendencies to help the patient foster a more positive outlook toward life. The result increased patient self-respect and quality of life. The authors hope this case may provide a reference for treating similar clinical cases in the future.

摘要

边缘型人格障碍(BPD)患者常常质疑自己生命的意义和价值。了解BPD患者的精神需求对于提供更恰当的护理以及提高护理效果至关重要。本病例报告研究了一名在护理期间经历精神困扰的BPD女性患者。2010年2月24日至12月15日期间,作者通过观察、访谈和患者病历对该患者的精神护理四个维度进行了评估。这四个维度包括个体与自身、他人、宗教信仰以及自然环境之间的关系。在整合和分析数据后,作者发现该患者因支持系统不足以及疾病引发的抑郁和童年苦难的长期影响导致缺乏有效的压力管理和应对技巧,从而质疑自己生命的意义和价值,并考虑过自我伤害/自杀。在护理过程中,作者采用一对一访谈并运用倾听技巧引导患者描述其精神困扰,然后采用辩证行为治疗小组和教育技能培训来强化积极思维的价值观并减少自杀/自我伤害倾向,以帮助患者培养更积极向上的生活态度。结果提高了患者的自尊和生活质量。作者希望本病例能为未来治疗类似临床病例提供参考。

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