一位血癌糖尿病人之糖尿病個案管理照護經驗

The Experience of Caring for an Elderly Diabetic Patient with Acute Myeloid Leukemia

顏閩嘉(Min-Chia Yen) ； 曾詩瑤(Shih-Yao Tseng) ； 邱敏惠(Min-Hui Chiu)

《新臺北護理期刊》 22卷1期 (2020/03) Pp. 97-105

https://doi.org/10.6540/NTJN.202003_22(1).0009

摘要

本文主旨在分享運用羅氏適應模式照護一位老年急性骨髓性白血病的糖尿病病人之護理經驗。照護期間為2016年2月29日至2016年7月19日，藉由傾聽、會談、身體評估、直接照護、護理指導、心理支持等方式，並運用羅氏適應模式評估及確立健康問題，發現過程中有因化療過程導致的無效性保護能力、面臨醫療照護的抉擇衝突以及照顧者角色緊張等問題，在筆者深入觀察與評估下，提供個別化的照護與衛教措施，提供其照護知識與技能，控制血糖值，並以同理心、接受與支持的態度，鼓勵表達情緒，陪伴個案渡過疾病導致的生理與心理改變，結合家庭支持系統，促進及達成適應的目標與健康狀態。期望藉此護理經驗的分享，提供臨床護理同仁及相同角色的家庭照顧者參考與應用。

關鍵字

糖尿病 ； 白血病 ； 羅氏適應模式

並列摘要

The purpose of this case report is to share the nursing experience of using Roy's Adaptation Model to care for an elderly diabetic patient with acute myeloid leukemia. The nursing manager provided diabetic health education from February 29, 2016 to July 19, 2016. I cared for the patient through diabetes counseling clinic, phone follow-ups, and ward visiting. Data were collected through listening, interviews, physical assessments, direct care, nursing instruction, and psychological support. Roy's Adaptation Model was used to identify and assess health problems. The problems were ineffective protection caused by chemotherapy, anxiety resulting from the pressures of choosing a form of treatment, and anxiety among the caregivers. Based on my careful observation and assessment, I provided individual care and education and imparted to the patient knowledge and skills about caring and how to control his blood sugar. I encouraged him to express his moods and stood by him through the physical and psychological changes caused by the disease. Together with the family's support system, I was able to improve his situation and achieve the goal of adaptation and health. I hope that my experience of nursing care can provide other nurses and caregivers with ideas and methods.

並列關鍵字

diabetes ； acute myeloid leukemia ； Roy's Adaptation Model

參考文獻

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