運用自我管理於三高合併腦中風病人之照護經驗

The Experience of Applying Self-Management in Patients with Hyperglycemia, Hyperlipidemia and Hypertension Plus Stroke

柳雅雲(Ya-Yun Liou) ； 徐琬茵(Wan-Yin Hsu) ； 鄭雪梅(Hsueh-Mei Cheng)

《高雄護理雜誌》 40卷2期 (2023/08) Pp. 177-188

https://doi.org/10.6692/KJN.202308_40(2).0015

摘要

本篇為三高慢性病個案併發腦中風之護理經驗。護理期間為2019年12月18日至12月27日，運用Gordon十一項健康功能評估，藉由觀察、會談及身體評估，確立個案有吞嚥功能障礙、肢體活動功能障礙、焦慮、無效性自我管理等問題。運用自我管理概念結合跨團隊醫療照護，執行吞嚥訓練，調整食物材質並採取安全進食姿勢及方式，預防吸入性肺炎發生進而成功移除鼻胃管；教導被動關節運動、漸進式肌力訓練、重覆性任務訓練，訓練肢體肌力及增進自我照護能力；運用傾聽、鼓勵表達內心感受，藉由個別性衛教指導降低焦慮感；導入自我健康維護、監測和管理，協助個案建立健康維護能力，重視慢性病管理，期望藉此護理經驗分享有助於提升照護腦中風個案之照護品質。

關鍵字

腦中風 ； 高血壓 ； 高血糖 ； 高血脂 ； 自我管理

並列摘要

This is a study exploring the experience of applying self-management in patients with hyperglycemia, hyperlipidemia, and hypertension plus stroke. During December 1-27, 2019, Gordon's 11 Functional Health Patterns was used to evaluate health issues such as dysphagia, physical disability, anxiety, invalid self-management through observation, interview and physical assessment. The authors applied interdisciplinary healthcare services in combination with the concepts of self-management to perform swallowing training, change food texture, adopt safe consumption position and approach prevention from aspiration pneumonia in further removal of the nasogastric tube. The patient's limb strength and self-care ability were also improved via passive range of motion, progressive muscle strengthening, and repetitive task training. By listening, encouragement of emotional expression, and individualized education in corporation with self-health maintenance, monitoring and management, not only was the patient's stress level was reduced, but the ability to health/chronic disease management were also improved. This shared nursing experience is expected to improve the quality of care for patients with stroke.

並列關鍵字

stroke ； hypertension ； hyperglycemia ； hyperlipidemia ； self-management

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