一位智能障礙糖尿病患者及其主要照顧者之個案管理經驗

A Case Management Experience of a Diabetes Patient with Mental Retardation

蔡牡丹(Mu-Dan Tsai) ； 徐少慧(Shao-Hui Shu)

《志為護理-慈濟護理雜誌》 14卷4期 (2015/08) Pp. 69-78

摘要

本文為協助一位糖尿病智能障礙者及其主要照顧者，簡化複雜的糖尿病自我管理行為，以增進對疾病的認知及能執行適當自我照護為目標，提昇疾病控制成效與調適身心壓力之照護經驗。護理期間自2013年9月2日至12月31日，運用整體評估模式、觀察及會談及電訪方式收集資料得個案問題為無效性健康維護能力、知識缺乏及主要照顧者無力感。筆者以個案管理介入，遊戲治療合併工作分析法改善個案學習障礙，漸進式引導個案及案母正確執行胰島素注射；透過簡易衛教圖卡與持續追蹤強化其對飲食、運動及血糖管理認知；協尋相關資源，發揮護理個別性，以正向疾病控制成效減輕照護者身心壓力與無力感。

關鍵字

糖尿病智能障礙者 ； 糖尿病自我管理 ； 主要照顧者

並列摘要

This is a case management experience of helping a diabetes patient with mental retardation and the primary caregiver strengthen the diabetes self-management abilities and behaviors, improve disease control, and cope with physical and psychological stresses. During the nursing period, between September 2^(nd) and December 31^(st) 2013, observation, interviews and phone surveys were carried out to collect information and evaluate the patient's health problems. The health problems included ineffective health maintenance, deficient knowledge related to diabetes and the powerlessness in primary caregiver. The author used case management intervention and combined play therapy with work analysis to improve the patient's learning ability and to familiarize the patient and his primary caregiver with the correct insulin injection. Simple picture cards with health education were also applied to follow up the learning effectiveness so to strengthen the diet, exercise and blood sugar management in daily life. Related resources and individualized nursing care were provided to promote effectiveness of disease control and to relieve caregiver's physical and psychological stresses and powerlessness.

並列關鍵字

diabetes patient with mental retardation ； diabetes self-management ； primary caregiver