本文目的為提升思覺失調症患者精神症狀聽幻覺護理評估與處置。描述一位首次發病女 性思覺失調症患者，因精神症狀幻聽干擾、拒絕服用藥物之護理評估與處置經驗。護理期間 自105 年7 月3 日至105 年7 月31 日。照護期間以治療性會談及護理觀察方式收集資料，並 且以整體性護理評估進行精神症狀幻聽評估。本案例護理主要問題以知覺障礙、藥物不遵從 兩項護理問題優先進行處置，護理需求面依序考量患者個別性與優先性提供照護策略。在照 護期間遵循精神科醫療處置，並以治療性人際關係及溝通技巧為互動基礎。以幻聽會談指引 評估精神症狀並且以同理、傾聽、接納、澄清提供適切護理指導。個案於出院前精神症狀幻 聽，及服藥問題獲得改善且對藥物遵從性處理能力與疾病的認知增加。思覺失調症個案之護 理，應覺察精神症狀續發之護理問題，提供個別及人性化之護理措施，進而穩定疾病症狀， 提升個案之照護與生活品質。藉由此經驗分享，累積臨床實證知識並作為精神科護理學習的 認識與應用。

The purpose of this paper is to improve the psychiatric symptom nursing assessment and disposal of patients with mental disorders. Describe a mental illness for the first time the incidence of female patients, due to symptoms of auditory hallucinations, refused to take drugs affect the quality of life care experience. The care period was from July 3 to July 31, 2016. We collected the patient’s clinical information by means of therapeutic interview and nursing care. With the overall assessment of the five levels of psychiatry, care is taken into account during individual care and priority care needs. The main concerns of this case care are sensory changes, and the drug does not follow two priorities for disposal. Follow psychiatric medical care during care and use therapeutic interpersonal and communication skills as an interactive basis. Use psychoanalysis guidelines to assess psychiatric symptoms and give right care guidance with listening, empathy, and attitudes. Psychiatric auditory hallucinations and medication problems improved during discharge and increased awareness of drug handling and disease. Nursing disorders should be aware of the symptoms of mental illness renewal of the care, to provide individual and human care measures, and thus stabilize the symptoms of the disease, to enhance the care and quality of life. This nursing experience suggests we should emphasize nursing problems caused by side effects of drugs and provide individualized nursing programs to reduce relapses and enhance the feasibility of returning patients to society. This nursing experience suggests we should emphasize nursing problems caused by the accumulation of clinical empirical knowledge and as a psychiatric nursing learning awareness and application.