摘要：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.