協助一位第1型糖尿病患者裝置連續型血糖監測儀及接受胰島素幫浦治療之護理經驗

Nursing Experience of Helping a Type 1 Diabetic Patient to Apply the Continuous Glucose Monitoring System (CGMS) and Receive Continuing Subcutaneous Insulin Infusion (CSII) Treatment

林秀珠(Hsiu-Chu Lin) ； 李佳倫(Chia-Lun Lee)

《高雄護理雜誌》 29卷1期 (2012/04) Pp. 80-95

https://doi.org/10.6692/KJN-2012-29-1-9

摘要

本文為協助一位第1型糖尿病患者裝置連續型血糖監測儀及接受胰島素幫浦治療的照護過程，照護期間為2007年12月1日迄今，在與個案多次會談、觀察、傾聽及電訪收集相關資料後，確立個案主要健康問題為：（一）潛在危險性不穩定血糖濃度/與血糖自我監測次數不足、胰島素注射部位不當及工作壓力大有關；（二）能力增進的準備度/與個案希望裝置連續型血糖監測儀、接受胰島素幫浦治療及期望血糖能控制良好有關；（三）焦慮/與血糖值不穩定、對裝置連續型血糖監測儀及接受胰島素幫浦治療不瞭解且過程不順利有關。筆者在與個案建立治療性關係後，進行學習動機與能力的評估，確認其決定裝置連續型血糖監測儀及接受胰島素幫浦治療，進而協助學習相關處理知識與技巧，共同討論並找出適合的問題解決方法，利用電話定期追蹤狀況，提供專線澄清疑惑並給予關心與支持，使個案能及時處理問題，確實執行糖尿病照護的相關措施，進而達到良好的血糖控制目標。

關鍵字

第1型糖尿病 ； 連續型血糖監測儀 ； 胰島素幫浦治療

並列摘要

This article of nursing experience explores a patient with type 1 diabetes mellitus who applied the Continuous Glucose Monitoring System (CGMS) and received the Continuing Subcutaneous Insulin Infusion (CSII) treatment in order to achieve better glycemic control. The case study period was between 12/01/2007 till time of writing. Problems relating to nursing care were collected through initial interviews, on-site observations, and follow-up telephone interviews. Major nursing related problems included: (1) risk of unstable blood glucose relating to blood sugar monitoring frequency was insufficient, inappropriate injection site, and job stress; (2) readiness for enhanced power relating to the CGMS & CSII application and blood glucose was well controlled; and (3) anxiety relating to blood glucose instability, lack of awareness and unfavorable CGMS & CSII application. In the nursing process, the author established a good relationship with the case and assessed the indications and ability of the female patient. When the patient made the decision, the author instructed her in the use of the devices, and explained the problem-solving knowledge and techniques when wearing the sensor at home. Furthermore, telephone interviews were regularly provided to check the patient's glycemic condition and applied care and support, to verify the ability of self-care, and ensure that the absence of treatment-emergent was not adverse. Good blood sugar control was achieved.

並列關鍵字

Type 1 DM ； Continuous Glucose Monitoring System (CGMS) ； Continuous Subcutaneous Insulin Infusion (CSII)