運用認知治療改善躁鬱症個案之憂鬱認知及情緒的護理經驗.

It is well known that cognitive therapy (CT) can be used effectively to improve negative thoughts and depressed mood in patients with depressive disorder. Little is known, however, about the effectiveness of CT in clients with depressive episodes of bipolar disorder. The purpose of this case report was therefore to demonstrate the nursing experience and effectiveness of implementing CT in client with depressive episode of bipolar disorder. Through interview, observation and comprehensive nursing assessment, data collection and problem identification, the following three major nursing diagnoses were made: deficit in self-care, social isolation and risk of violence (toward self). We also found that the client’s negative thoughts were demonstrated in the dimensions of herself, social relationships and life events. Nursing interventions were implemented in assisting the client to identify automatic thoughts, clarify the evidence supporting and not supporting her negative thoughts, and to perform training assignments at home throughout her cognitive therapy training. The results revealed that the client’s motivation to perform self-exploration was increased, her thinking became more positive and her emotions improved gradually. Her personal hygiene and interpersonal relationships were also improved. The results of this case report have important implications for psychiatric mental health nurses applying CT in caring for clients with depressive episodes of bipolar disorder.