- 期刊
運用自我管理於一位糖尿病患者合併多重症狀之照護經驗
The Nursing Experience of Applying Self-Management to the Care of a Diabetes Mellitus Case Complicated with Multiple Symptoms
摘要
本文為照護一位因糖尿病控制不佳及不良健康行為，而引發高血糖、急性腎盂腎炎及腸胃道出血之個案。照護期間為2018/6/28－7/14，以Gordon 11項健康功能型態進行評估，藉由照護、會談等方式，確立護理問題為血糖濃度不穩定、排尿型態障礙、組織灌流失效：腸胃及無效性健康維護能力。以關懷、同理及傾聽等方式建立治療性關係，了解日常健康處理狀況，引導表達內心感受，利用護理知識結合跨團隊資源，如與營養師共同設計個案之糖尿病飲食，並會同社工提供資源協助，利用圖像式升糖飲食卡及舒緩身心壓力運動等個別性護理措施，教導正確血糖控制，導正疾病認知，並將家屬列入照護成員中的一環，增強維護自身健康之意念，於個案做出正確自我照護行為時，給予心理支持及鼓勵，提升其糖尿病自我管理認知及自我照護行為，有效的自我健康管理，可避免疾病併發症復發及延緩合併症產生。
並列摘要
This paper depicts a diabetes mellitus case inciting hyperglycemia, acute pyelonephritis, and gastrointestinal bleeding due to poor control and poor health behaviors. Nursing care was provided from June 28th to July 14th, 2018. Assessment was made with the Gordon 11 Function Health Patterns, and nursing problems were identified through nursing care and interview which included unstable blood glucose level, impaired urinary elimination and ineffective tissue perfusion, and gastrointestinal and ineffective health maintenance. A therapeutic relationship was established by means of caring, empathy, and listening in order to understand the patient's daily health management status and guide her in expressing her feelings. Individualized nursing measures were provided using nursing knowledge with team resource. For example, a DM diet was designed for the patient with nutritionists, and resource assistance with social workers was provided using image-based glycemic diet cards and measures such as exercises to relieve physical and mental stress, while instruction was also provided on the correct way of glycemic control and correct illness perception. Moreover, family members were included as targets of nursing care so that the concept of maintaining one's own health was strengthened. Psychological support and encouragement were given when the patient performed correct self-care behaviors to reinforce their self-management awareness for diabetes mellitus and self-care behaviors. Effective health self-management could thereby prevent relapse of complications and postpone occurrence of comorbidities.