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[使用镜像视觉反馈对一名伴有视幻觉的精神分裂症患者的护理经验]

[Nursing Experience of Using Mirror Visual Feedback for a Schizophrenia Patient With Visual Hallucinations].

作者信息

Lan Shu-Ling, Chen Yu-Chi, Chang Hsiu-Ju

机构信息

BSN, RN, Formerly Nurse, Department of Nursing, Taipei Veterans General Hospital, Yuanshan Branch, Taiwan, ROC.

BSN, RN, Department of Nursing, Taipei Veterans General Hospital, Yuanshan Branch, Taiwan, ROC.

出版信息

Hu Li Za Zhi. 2018 Jun;65(3):103-111. doi: 10.6224/JN.201806_65(3).14.

Abstract

The aim of this paper was to describe the nursing application of mirror visual feedback in a patient suffering from long-term visual hallucinations. The intervention period was from May 15th to October 19th, 2015. Using the five facets of psychiatric nursing assessment, several health problems were observed, including disturbed sensory perceptions (prominent visual hallucinations) and poor self-care (e.g. limited abilities to self-bathe and put on clothing). Furthermore, "caregiver role strain" due to the related intense care burden was noted. After building up a therapeutic interpersonal relationship, the technique of brain plasticity and mirror visual feedback were performed using multiple nursing care methods in order to help the patient suppress her visual hallucinations by enhancing a different visual stimulus. We also taught her how to cope with visual hallucinations in a proper manner. The frequency and content of visual hallucinations were recorded to evaluate the effects of management. The therapeutic plan was formulated together with the patient in order to boost her self-confidence, and a behavior contract was implemented in order to improve her personal hygiene. In addition, psychoeducation on disease-related topics was provided to the patient's family, and they were encouraged to attend relevant therapeutic activities. As a result, her family became less passive and negative and more engaged in and positive about her future. The crisis of "caregiver role strain" was successfully resolved. The current experience is hoped to serve as a model for enhancing communication and cooperation between family and staff in similar medical settings.

摘要

本文旨在描述镜像视觉反馈在一名长期遭受视幻觉困扰患者中的护理应用。干预期为2015年5月15日至10月19日。运用精神科护理评估的五个方面,观察到了几个健康问题,包括感觉知觉紊乱(突出的视幻觉)和自我护理能力差(如自我洗澡和穿衣能力有限)。此外,还注意到由于相关的高强度护理负担导致的“照顾者角色紧张”。在建立治疗性人际关系后,采用多种护理方法实施脑可塑性技术和镜像视觉反馈,以通过增强不同的视觉刺激来帮助患者抑制视幻觉。我们还教她如何以适当的方式应对视幻觉。记录视幻觉的频率和内容以评估管理效果。与患者共同制定治疗计划以增强她的自信心,并实施行为契约以改善她的个人卫生状况。此外,还向患者家属提供了有关疾病相关主题的心理教育,并鼓励他们参加相关治疗活动。结果,她的家人变得不那么消极被动,而是更多地参与并积极看待她的未来。“照顾者角色紧张”的危机得以成功解决。希望当前的经验能成为类似医疗环境中加强家庭与医护人员之间沟通与合作的典范。

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