MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_01C44715.CFB1FC50" This document is a Web archive file. If you are seeing this message, this means your browser or editor doesn't support Web archive files. For more information on the Web archive format, go to http://officeupdate.microsoft.com/office/webarchive.htm ------=_NextPart_01C44715.CFB1FC50 Content-Location: file:///C:/85899A50/10.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" 危機處理Q & A （十）</= title> <!--[if gte mso 9]><xml> <o:DocumentProperties> <o:Author>ET</o:Author> <o:Template>Normal</o:Template> <o:LastAuthor>ET</o:LastAuthor> <o:Revision>2</o:Revision> <o:TotalTime>4</o:TotalTime> <o:Created>2004-05-31T05:47:00Z</o:Created> <o:LastSaved>2004-05-31T05:47:00Z</o:LastSaved> <o:Pages>1</o:Pages> <o:Words>744</o:Words> <o:Characters>4247</o:Characters> <o:Company>ASUS</o:Company> <o:Lines>35</o:Lines> <o:Paragraphs>9</o:Paragraphs> <o:CharactersWithSpaces>4982</o:CharactersWithSpaces> <o:Version>10.4219</o:Version> </o:DocumentProperties> </xml><![endif]--><!--[if gte mso 9]><xml> <w:WordDocument> <w:SpellingState>Clean</w:SpellingState> <w:GrammarState>Clean</w:GrammarState> <w:Compatibility> <w:UseFELayout/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--> <style> <!--.MENUSKIN {position:absolute; 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1.0pt;mso-border-alt:inset white .75pt; padding:0cm 0cm 0cm 0cm;height:34.5pt'> <p align=3Dcenter style=3D'margin-top:3.75pt;margin-right:0cm;margin-bott= om:3.75pt; margin-left:0cm;text-align:center'><span lang=3DEN-US style=3D'font-size:= 10.0pt'><a href=3D"http://www.edu.tw/displ/index.htm"><span style=3D'color:black'>&#= 25945;育部訓委會</span></a><span class=3DGramE><span style=3D'color:black'>│</span></span><span style=3D'color:black'>關於本站與導<sp= an class=3DGramE>覽│</span><a href=3D"http://sars.ncue.edu.tw/po= licy.htm"></a></span><a href=3D"http://sars.ncue.edu.tw/policy.htm"><span style=3D'color:black'>&= #25919;策與相關法律</span></a><span class=3DGramE><span style=3D'color:black'>│</span></span><span style=3D'color:black'><a href=3D"file:///C:\Documents%20and%20Settings\魏嘉宏\My= %20Documents\我的網站\Q&A.htm"></a></span><a href=3D"file:///C:\Documents%20and%20Settings\魏嘉宏\My= %20Documents\我的網站\Q&A.htm"><span style=3D'color:black'>災害應變及心= 9702;輔導Q&A</span></a><span class=3DGramE><span style=3D'color:black'>│</span></span></span><sp= an lang=3DEN-US><a href=3D"file:///C:\Documents%20and%20Settings\魏嘉宏\My= %20Documents\我的網站\Q&A.htm" onmouseover=3D"showmenu(event,linkset[0])" onmouseout=3D"delayhidemenu()"= ><span style=3D'font-size:10.0pt;color:black'>心理輔導&#= 25991;章</span></a></span><span class=3DGramE><span style=3D'font-size:10.0pt;color:black'>│</span>= </span><span lang=3DEN-US style=3D'font-size:10.0pt;color:black'><a href=3D"http://sars.ncue.edu.tw/article.htm"></a></span><span lang=3DEN-US style=3D'font-size:10.0pt'><a href=3D"http://sars.ncue.edu.tw/article.htm= "><span style=3D'color:black'>災害應變文章</s= pan></a><span class=3DGramE><span style=3D'color:black'>│</span></span><a href=3D"file:///C:\Documents%20and%20Settings\魏嘉宏\My= %20Documents\我的網站\Q&A.htm" onmouseover=3D"showmenu(event,linkset[2])" onmouseout=3D"delayhidemenu()"= ><span style=3D'color:black'>E-mail網路專家諮Ţ= 26;</span></a> <o:p></o:p></span></p> <p align=3Dcenter 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pan><a href=3D"http://sars.ncue.edu.tw/phpbb2/"><span style=3D'color:black'>#= 342;論區</span></a><span class=3DGramE><span style=3D'color:black'>│</span></span><span style=3D'color:black'><a href=3D"http://sars.ncue.edu.tw/newspaper/"></a>= </span><a href=3D"http://sars.ncue.edu.tw/newspaper/"><span style=3D'color:black'>&= #38651;子報訂閱</span></a><span class=3DGramE><span style=3D'color:black'>│</span></span><span style=3D'color:black'><a href=3D"http://sars.ncue.edu.tw/psyweb.htm"></a>= </span><a href=3D"http://sars.ncue.edu.tw/psyweb.htm"><span style=3D'color:black'>&= #30456;關心理輔導網站</span></a><= span class=3DGramE><span style=3D'color:black'>│</span></span><span style=3D'color:black'><a href=3D"http://sars.ncue.edu.tw/medicalweb.htm">= </a></span><a href=3D"http://sars.ncue.edu.tw/medicalweb.htm"><span style=3D'color:blac= k'>相關災害應變網站</span><= /a><o:p></o:p></span></p> </td> </tr> <tr style=3D'mso-yfti-irow:2;mso-yfti-lastrow:yes;height:123.0pt'> <td valign=3Dtop style=3D'border:inset red 1.0pt;mso-border-alt:inset red= .75pt; padding:0cm 0cm 0cm 0cm;height:123.0pt'> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 = width=3D600 style=3D'width:450.0pt;mso-cellspacing:0cm;background:red;mso-padding-al= t: 0cm 0cm 0cm 0cm' height=3D18> <tr style=3D'mso-yfti-irow:0;height:15.0pt'> <td width=3D594 style=3D'width:445.5pt;padding:0cm 0cm 0cm 0cm;height:1= 5.0pt'> <p align=3Dcenter style=3D'text-align:center'><b><span style=3D'font-si= ze:18.0pt; color:white'>災害應變及心理&#= 36628;導<span lang=3DEN-US>Q&A</span></span></b></p> </td> </tr> <tr style=3D'mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td width=3D598 style=3D'width:448.5pt;background:white;padding:0cm 0cm= 0cm 0cm'> <p class=3DMsoNormal align=3Dcenter style=3D'margin-top:15.0pt;text-ali= gn:center; line-height:150%'><span style=3D'font-size:18.0pt;line-height:150%; color:#CC0000'>危機處理<span lang=3DEN-US>Q &am= p; A （十）</span></span></p> <p class=3DMsoNormal align=3Dright style=3D'margin-top:7.5pt;text-align= :right; line-height:22.0pt'><span style=3D'font-family:DFKai-SB;color:black'>&#= 21271;市景美女中 輔導教師<span lang=3DEN-US> 張জ= 9;敏</span></span></p> <div class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span lang=3DEN-US> <hr size=3D2 width=3D"100%" align=3Dcenter> </span></div> <p class=3DMsoNormal style=3D'margin-left:27.05pt;text-indent:-27.05pt; mso-char-indent-count:-2.25'><b>問題：<span lang=3DEN= -US><o:p></o:p></span></b></p> <p class=3DMsoNormal style=3D'margin-left:27.0pt;mso-para-margin-left:2= .25gd'>我是一個高中的輔= 566;老師，目前我正輔導= ;一位疑似<span class=3DGramE>罹</span>患精神分裂&#= 30151;的個案（因在輔導ű= 42;程中發現個案有幻聽= 、妄想的情形），請= 1839;我該如何與個案的फ= 8;長溝通、取得家人的&= #21512;作來協助個案接受%= 291;療呢？</p> <p class=3DMsoNormal style=3D'margin-left:27.0pt;text-indent:-27.0pt; mso-char-indent-count:-2.25'>＝＝＝＝＝&#= 65309;＝＝＝＝＝＝＝＝ʍ= 09;＝＝＝＝＝＝＝＝＝= ＝＝＝＝＝＝＝＝＝= 5309;</p> <p class=3DMsoNormal style=3D'margin-left:27.05pt;text-indent:-27.05pt; mso-char-indent-count:-2.25'><b>答案：<span lang=3DEN= -US><o:p></o:p></span></b></p> <p class=3DMsoNormal style=3D'margin-left:27.0pt;mso-para-margin-left:2= .25gd'>謝謝這位老師的提= 839;，這是一個很好的問= ;題。首先，我們在這&#= 35041;對先精神分裂症做Ì= 91;簡單的說明。</p> <p class=3DMsoNormal style=3D'margin-left:27.0pt;text-indent:-27.0pt; mso-char-indent-count:-2.25'><span lang=3DEN-US><o:p> </o:p></span= ></p> <p class=3DMsoNormal><b>【精神分裂症= ;】<span lang=3DEN-US><o:p></o:p></span></b></p> <p class=3DMsoNormal>一、什麼是精&#= 31070;分裂症？</p> <p class=3DMsoNormal style=3D'margin-left:3.0pt;text-indent:21.0pt'>= 1934;神分裂症是一種<span class=3DGramE>腦部的疾病</span>，&#= 23427;常會影響一個人的ö= 05;考、情緒、行為、人= 際關係、就學就業…<span class=3DGramE>…</span>等方面的能= 1147;，目前在世界上的௢= 7;行率約在<span lang=3DEN-US>1%左右。這個疾病= 雖然目前還不清楚真= 7491;的病因，但是目前௚= 0;醫療已能有效控制疾&= #30149;的惡化以及增加患 = 773;的生活功能。</span></p> <p class=3DMsoNormal style=3D'margin-left:3.0pt;text-indent:21.0pt'><sp= an lang=3DEN-US><o:p> </o:p></span></p> <p class=3DMsoNormal>二、精神分裂&#= 30151;的病因：</p> <p class=3DMsoNormal style=3D'margin-left:3.0pt;text-indent:21.0pt'>= 1934;神分裂症可能發生ࢷ= 2;任何人身上，但是在&= #38738;少年至<span lang=3DEN-US>30歲<span class=3DGramE>左右間= 159;好</span>發的年紀。醫學= 界曾經探討過遺傳、= 2522;因是否造成<span class=3DGramE>罹</span>病的可能性&#= 65292;但是目前沒有定論ʌ= 92;只能<span class=3DGramE>說若有罹</span>患疾&#= 30149;的家屬、親戚，那Ɩ= 36;可能會提高<span class=3DGramE>罹</span>患精神分裂&#= 30151;的危險性。若以「ī= 83;物-心理-社會」的疾ெ= 9;模式來看，造成精神&= #20998;裂症的原因除了遺= 659;的生理因素外，仍有= ;許多其他的可能性。</= span></p> <p class=3DMsoNormal><span lang=3DEN-US><o:p> </o:p></span></p> <p class=3DMsoNormal>三、精神分裂&#= 30151;的症狀</p> <p class=3DMsoNormal style=3D'margin-left:3.0pt;text-indent:21.0pt'>= 1934;神分裂症的症狀通६= 0;分為兩大類：正性症&= #29376;、負性症狀。</p> <p class=3DMsoNormal style=3D'margin-left:108.0pt;text-indent:-84.0pt'>= （一）「正性症狀」= 5306;所謂正性症狀指的਷= 9;一些一般人不會存在&= #30340;症狀，患者卻有的= 773;況，包括「妄想」與= ;「幻覺」。這兩者使&#= 24471;精神分裂症的患者ć= 77;脫離現實、喪失現實= 感、思想混亂、語無= 0523;次的狀況。</p> <p class=3DMsoNormal style=3D'margin-left:90.0pt;text-indent:-66.0pt'><= span lang=3DEN-US>1.妄想：精神分裂= 症的患者有時候會有= 4618;異或與現實脫節的঱= 9;法，這些想法似乎自&= #26377;一套邏輯系統，且= 739;者對妄想內容深信不= ;疑。</span></p> <p class=3DMsoNormal style=3D'margin-left:90.0pt;text-indent:-66.0pt'><= span lang=3DEN-US>2.幻覺：幻覺多以= 幻聽呈現，少數有視= 4187;覺、觸幻覺…<span class=3DGramE>…</span>等症狀。幻= 2893;的內容常是在批評ӌ= 9;指責患者，讓患者痛&= #33510;不已。</span></p> <p class=3DMsoNormal style=3D'margin-left:90.0pt;text-indent:-66.0pt'><= span lang=3DEN-US><o:p> </o:p></span></p> <p class=3DMsoNormal style=3D'margin-left:99.0pt;text-indent:-75.0pt'>&= #65288;二）「負性症狀」A= 306;所謂負性症狀指的是= ;一般人擁有而患者卻&#= 27794;有的特質。包括：÷= 73;感平淡、動機缺乏、= 說話內容貧乏、對生= 7963;事物沒有興趣，這ߜ= 3;狀況亦會影響患者的&= #26085;常生活功能。</p> <p class=3DMsoNormal style=3D'margin-left:99.0pt;text-indent:-75.0pt'><= span lang=3DEN-US>1.情感平淡：精神= 分裂症患者在表達情= 4863;方面會有困難，包৤= 4;：情緒表達少、笑得&= #23569;、哭得也少。有些= 739;者會有一段時間表現= ;出社會退縮與人際孤&#= 31435;。</span></p> <p class=3DMsoNormal style=3D'margin-left:99.0pt;text-indent:-75.0pt'><= span lang=3DEN-US>2.動機缺乏：精神= 分裂患者常缺乏做事= 4773;的動機，尤其在開ࣺ= 7;計畫一件事或開始執&= #34892;一件事情時有困難 = 290;</span></p> <p class=3DMsoNormal style=3D'margin-left:99.0pt;text-indent:-75.0pt'><= span lang=3DEN-US>3.說話內容貧乏：= 精神疾病患者常因思= 2771;貧乏而使得語言也ฐ= 7;乏，尤其<span class=3DGramE>在說新的</span>事情&#= 19978;面。</span></p> <p class=3DMsoNormal style=3D'margin-left:99.0pt;text-indent:-75.0pt'><= span lang=3DEN-US>4.對生活事物沒有= 興趣：精神疾病患者= 5258;得身邊的一切事情๿= 7;很無趣，覺得做什麼&= #37117;沒有意義與樂趣、= 863;到無聊。</span></p> <p class=3DMsoNormal style=3D'margin-left:99.0pt;text-indent:-75.0pt'><= span lang=3DEN-US><o:p> </o:p></span></p> <p class=3DMsoNormal>四、精神分裂&#= 30151;的診斷：</p> <p class=3DMsoNormal style=3D'margin-left:3.0pt;text-indent:21.0pt'>= 6681;據心理疾病診斷與ಋ= 3;計手冊（<span lang=3DEN-US>APA,1994），符合下列&#= 35386;斷標準的人極可能<span class=3DGramE>罹</span>患精神分裂&#= 30151;：</span></p> <p class=3DMsoNormal style=3D'margin-left:42.0pt;text-indent:-18.0pt; mso-pagination:none;mso-list:l0 level1 lfo2;tab-stops:list 42.0pt'><![i= f !supportLists]><span lang=3DEN-US><span style=3D'mso-list:Ignore'>1.<span style=3D'font:7.0p= t "Times New Roman"'>      </span></span></span><![endif]>下列症狀中= 出現至少兩個症狀：</p> <p class=3DMsoNormal style=3D'margin-left:24.0pt'>（<span lang=3D= EN-US>1）妄想</span></p> <p class=3DMsoNormal style=3D'margin-left:24.0pt'>（<span lang=3D= EN-US>2）幻聽</span></p> <p class=3DMsoNormal style=3D'margin-left:24.0pt'>（<span lang=3D= EN-US>3）語無倫次</span></p> <p class=3DMsoNormal style=3D'margin-left:3.0pt;text-indent:21.0pt'>= 5288;<span lang=3DEN-US>4）混亂或僵直行&= #28858;</span></p> <p class=3DMsoNormal style=3D'margin-left:3.0pt;text-indent:21.0pt'>= 5288;<span lang=3DEN-US>5）負向症狀，<span class=3DGramE>如面無</span>表情、&#= 32570;乏動機、思想不合Ų= 07;輯</span></p> <p class=3DMsoNormal style=3D'margin-left:42.0pt;text-indent:-18.0pt; mso-pagination:none;mso-list:l0 level1 lfo2;tab-stops:list 42.0pt'><![i= f !supportLists]><span lang=3DEN-US><span style=3D'mso-list:Ignore'>2.<span style=3D'font:7.0p= t "Times New Roman"'>      </span></span></span><![endif]>症狀明顯影= 響社會職業功能</p> <p class=3DMsoNormal style=3D'margin-left:42.0pt;text-indent:-18.0pt; mso-pagination:none;mso-list:l0 level1 lfo2;tab-stops:list 42.0pt'><![i= f !supportLists]><span lang=3DEN-US><span style=3D'mso-list:Ignore'>3.<span style=3D'font:7.0p= t "Times New Roman"'>      </span></span></span><![endif]>症狀持續至= 少六個月，其中急性= 0151;狀出現至少一個月Ӎ= 0;</p> <p class=3DMsoNormal style=3D'margin-left:42.0pt;text-indent:-18.0pt; mso-pagination:none;mso-list:l0 level1 lfo2;tab-stops:list 42.0pt'><![i= f !supportLists]><span lang=3DEN-US><span style=3D'mso-list:Ignore'>4.<span style=3D'font:7.0p= t "Times New Roman"'>      </span></span></span><![endif]>症狀不是因= 為藥物或生理疾病造= 5104;的。</p> <p class=3DMsoNormal><span lang=3DEN-US><o:p> </o:p></span></p> <p class=3DMsoNormal>五、精神分裂&#= 30151;的治療：</p> <p class=3DMsoBodyTextIndent style=3D'margin-left:24.0pt'>對Ą= 44;精神分裂症的治療，= 可分為急性治療與預= 8450;（持續和維持）治௓= 4;兩大類：</p> <p class=3DMsoNormal style=3D'margin-left:99.0pt;mso-para-margin-left:1= .5gd; text-indent:-81.0pt;mso-char-indent-count:-6.75'>（一ᦀ= 9;急性治療：治療的目&= #27161;在結束急性精神症= 376;，嚴重時可能需要住= ;院治療。急性治療主&#= 35201;以抗精神疾病藥物Ġ= 58;主，藥物可以幫助解= 除失控的急性精神症= 9376;，而在急性期過後ᦁ= 2;藥物的持續使用可以&= #28187;少急性症狀再發的= 231;會。</p> <p class=3DMsoNormal style=3D'margin-left:90.0pt;mso-para-margin-left:2= .0gd; text-indent:-66.0pt;mso-char-indent-count:-5.5'>（二）= ;預防治療：主要目標&#= 22312;改善患者的功能、ƅ= 28;防精神症狀的復發。= 這個時期除了藥物治= 0274;，心理治療亦是很ດ= 5;要的。心理治療主要&= #22312;幫助精神疾病患者!= 287;家屬處理壓力、調適= ;情緒、解決問題、以&#= 21450;鼓勵接受服藥。一Ą= 41;面教育患者家屬如何= 與精神分裂症患者相= 4389;、預防併發症及減ऴ= 9;復發。</p> <p class=3DMsoNormal>六、精神分裂&#= 30151;的預後：</p> <p class=3DMsoNormal style=3D'text-indent:24.0pt'>大致Ë= 58;說，成年後發病的患= 者預後較好。而早期= 5386;斷、適當治療（包৤= 4;藥物與心理治療）可&= #20197;延緩症狀復發，因= 858;每次急性發作都會使= ;得患者功能喪失越多&#= 12289;越難治療。</p> <p class=3DMsoNormal><span lang=3DEN-US><o:p> </o:p></span></p> <p class=3DMsoNormal><b>【如何邀請家= ;屬合作協助個案就醫&#= 12305;<span lang=3DEN-US><o:p></o:p></span></b></p> <p class=3DMsoNormal><span lang=3DEN-US><span style=3D'mso-tab-count:1'= >        </span>以下將= 分五點說明：</span></p> <p class=3DMsoNormal>一、與個案家&#= 23660;建立良好的關係</p> <p class=3DMsoNormal><span lang=3DEN-US><span style=3D'mso-tab-count:1'= >        </span><span style=3D'mso-spacerun:yes'> </span>通常認識= ;個案的父母可以幫助&#= 25105;們對個案有更多的Ţ= 69;識與瞭解，一方面評= 估個案的家屬有多少= 3021;力可以提供個案正ࡨ= 1;的支持，一方面瞭解&= #20491;案與家人的互動情= 841;是否有需要協助之處= ;。我們常可以從與家&#= 23660;的談話相處中瞭解ê= 78;屬情緒的表達、人際= 關係、對個案的瞭解= 1243;度與對個案狀況的৶= 9;受程度。所以，在最&= #22909;的狀況下，盡量以&= 754;談代替電話談話，可= ;以邀請個案的家屬到&#= 24744;的服務單位，讓家ì= 60;認識您、認識個案晤= 談的地方，讓個案的= 3478;屬能夠感受到您的ො= 8;意，容易對您產生信&= #20219;感。</span></p> <p class=3DMsoNormal><span lang=3DEN-US><o:p> </o:p></span></p> <p class=3DMsoNormal>二、同理家屬</= p> <p class=3DMsoNormal><span lang=3DEN-US><span style=3D'mso-tab-count:1'= >        </span>與家屬= 談話時同樣要帶著同= 9702;、傾聽的態度。往ঌ= 8;我們會急著要家屬聽&= #21040;我們<span class=3DGramE>要說的</span>，並且&#= 24076;望對方很快地接受û= 05;們希望他們合作的地= 方，而這過程中往往= 4573;略掉家屬的需要被ਞ= 3;持的情緒。尤其，我&= #20497;需要在過程中讓家= 660;知道個案<span class=3DGramE>罹</span>患精神分裂&#= 30151;並不完全是他們的Ÿ= 79;或甚至是罪過，同理= 他們羞愧、自責的心= 4773;，陪伴他們一起面ऴ= 5;個案的狀況、協助家&= #23660;接受個案生病的事= 526;。</span></p> <p class=3DMsoNormal><span lang=3DEN-US><o:p> </o:p></span></p> <p class=3DMsoNormal>三、與家屬清&#= 26970;說明個案的情況</p> <p class=3DMsoNormal><span lang=3DEN-US><span style=3D'mso-tab-count:1'= >        </span>輔導人= 員需清楚地舉例說明= 0491;案的情況，像您在ࢇ= 9;題中提到個案有幻聽&= #12289;妄想的情況，這些%= 096;分需要條列式地以例= ;子做說明，接著利用&#= 36889;些例子說明為何我Ì= 97;懷疑個案可能<span class=3DGramE>罹</span>患精神分裂&#= 30151;，哪些部分是符合š= 86;斷的標準，在這些情= 況下我們需要醫生做= 6356;明確的診斷與治療Ӎ= 0;</span></p> <p class=3DMsoNormal><span lang=3DEN-US><span style=3D'mso-tab-count:1'= >        </span>通常在= 這個部分家屬會對症= 9376;有很多的疑惑，例ࣳ= 4;：「妄想和想像有什&= #40636;不同？」我們知道= 819;像是一種主動的、虛= ;構的、<span class=3DGramE>遊戲式的幻想</span>&#= 65292;想像的人知道自己Ē= 91;在幻想，但是精神分= 裂症的患者卻認為自= 4049;的妄想是真實的、ढ= 4;在的，即使與事實不&= #31526;。</span></p> <p class=3DMsoNormal><span lang=3DEN-US><span style=3D'mso-tab-count:1'= >        </span>諸如此= 類的疑問，輔導老師= 1487;以適時解惑。因此๎= 8;導老師在與個案家屬&= #35527;話前，需先對精神= 998;裂症有充分的認識，= ;除了參考相關資料外&#= 65292;亦可以請教專業、ć= 77;經驗的督導人員。</span><= /p> <p class=3DMsoNormal><span lang=3DEN-US><span style=3D'mso-tab-count:1'= >        </span>家屬另= 一類的疑問是有關精= 1070;分裂症的<span class=3DGramE>罹</span>病病因。有&#= 26178;家屬會問：「是不ą= 59;在她小時候我跟她母= 親離婚有關？」、「= 6159;不是她太用功、太਼= 2;睡、給自己太大壓力&= #25165;會有聽到聲音的情= 841;？」我們也需要清楚= ;告訴家屬目前在臨床&#= 19978;對病因的解釋，雖ġ= 82;目前醫學界知道的仍= 有限，但是這部分可= 0197;幫助家屬不會做錯ෝ= 2;的推論、給予個案錯&= #35492;且不適當的幫助。<span class=3DGramE>此外，</span>也可以&#= 19968;方面詢問家族病史z= 89;並盡量減低家屬的罪= 惡感與愧疚感。</span></p> <p class=3DMsoNormal><span lang=3DEN-US><span style=3D'mso-tab-count:1'= >        </span></span></p> <p class=3DMsoNormal>四、與家屬說&#= 26126;疾病的衛教知識</p> <p class=3DMsoNormal><span lang=3DEN-US><span style=3D'mso-tab-count:1'= >        </span>當家屬= 認識個案可能<span class=3DGramE>罹</span>患的是精神&#= 20998;裂症之後，我們需Š= 01;對疾病的病程、治療= 以及預後做<span class=3DGramE>清楚的</span>說明。&#= 39318;先我們需要告訴家ì= 60;為什麼精神分裂症的= 治療需要藥物治療與= 4515;理治療、兩者主要ࢷ= 2;幫助個案什麼、以及&= #28858;什麼需兩者雙管齊= 979;能達到最好的效果。= ;</span></p> <p class=3DMsoNormal><span lang=3DEN-US><span style=3D'mso-tab-count:1'= >        </span>家屬對= 於心理治療的<span class=3DGramE>疑問遠少過於</span>&#= 23565;藥物治療的擔憂，ñ= 20;見的疑問是：「一定= 要吃藥嗎？」、「藥= 9289;會不會有副作用？ӎ= 1;、「藥物需要吃多久&= #65311;」…<span class=3DGramE>…</span>。當家屬有= 6889;些疑問時，也是我ࠁ= 7;開始說明如何接受醫&= #30274;的好時機，我們可= 197;說明看醫生的過程與= ;狀況、哪些部分需要&#= 36319;醫生做<span class=3DGramE>清楚的</span>說明、&#= 22914;何配合醫囑服藥、Ĭ= 70;服藥有狀況時需要告= 知醫生…<span class=3DGramE>…</span>。當家屬越= 0637;解醫療可以協助的਷= 9;什麼，家屬也就容易&= #33287;醫生配合。</span></p> <p class=3DMsoNormal><span lang=3DEN-US><span style=3D'mso-tab-count:1'= >        </span>接下來= ，家屬更關心的可能= 6159;個案的預後情形。ৎ= 5;們可以告知家屬治療&= #30340;目的主要在緩解症= 376;，而疾病經過治療會= ;好到什麼程度，我們&#= 20173;須看個案的狀況。Þ= 40;為每一個<span class=3DGramE>罹</span>患精神分裂&#= 30151;的人症狀輕重不同ʍ= 07;而個案還是高中生，= 年紀還小，身心仍在= 0332;展中，所以也不容ਵ= 1;知道疾病會發展到什&= #40636;程度；<span class=3DGramE>此外，</span>也需要&#= 35222;個案對藥物與心理Ė= 35;療的配合程度，如果= 個案的病識感較好，= 7835;療的效果也會較好Ӎ= 0;在這期間個案的自我&= #29031;顧、課業、人際關= 418;都會有退化的情況，= ;若退化的程度少、功&#= 33021;較好，個案未來的ĥ= 76;況也會比較好。</span></p> <p class=3DMsoNormal><span lang=3DEN-US><o:p> </o:p></span></p> <p class=3DMsoNormal>五、與家屬說&#= 26126;如何在生活中與個Ċ= 96;相處</p> <p class=3DMsoNormal style=3D'text-indent:24.0pt'>家屬ß= 12;生活中或多或少會感= 覺到與個案是難以溝= 6890;、相處的，我們可ߣ= 7;協助家屬試著認識並&= #19988;接受這就是個案的= 151;狀，冷靜下來，不要= ;跟個案辯論。在臨床&#= 30740;究中，高情緒表達į= 40;家庭對精神分裂症患= 者的復<span class=3DGramE>原有著</span>負面的&#= 24433;響，因此，對家屬Ë= 58;說，試著學習新的互= 動方式，並幫助個案= 9968;起找出適當的情緒৛= 4;解方法是很重要的。<= /p> <p class=3DMsoNormal><span lang=3DEN-US><span style=3D'mso-tab-count:1'= >        </span>由於個= 案是高中生，大部分= 3478;屬也很關心個案的थ= 6;校適應與生涯議題，&= #36889;部份我們仍須視個= 696;的功能來做衡量。通= ;常，我們還是鼓勵個&#= 26696;能來學校盡量來，Ê= 94;是真的有困難時，需= 要家長、老師給予包= 3481;，在符合校規的範ࢴ= 5;內適度允許個案請假&= #12290;一般來說，學校都= 076;望能協助個案完成階= ;段的學業目標。</span></p> <p class=3DMsoNormal><span lang=3DEN-US><o:p> </o:p></span></p> <p class=3DMsoNormal style=3D'margin-left:27.0pt;text-indent:-27.0pt; mso-char-indent-count:-2.25'><span lang=3DEN-US><span style=3D'mso-tab-= count: 1'>         </span>希= 395;以上的說明能對您在= ;實務工作上有所幫助&#= 12290;</span></p> <div 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