一位養護機構長者糖尿病足之護理經驗

Nursing Care and Teaching Self Care Techniques for Elderly Diabetic from Resident of a Long-term Care Facility

林玉卿(Yu-Ching Lin) ； 江士青(Shyh-Ching Jiang) ； 蔡佳樺(Chia-Hwa Tsai)

《北市醫學雜誌》 5卷6_S期 (2008/12) Pp. 727-736

https://doi.org/10.6200/TCMJ.2008.5.6.16

摘要

本篇報告旨在描述照顧一位80歲糖尿病足患者，因糖尿病足部感覺減弱，造成足部傷口破皮紅腫之護理經驗。護理期間為2006年11月6日至2006年12月4止，運用Golden十一項健康評估模式為評估架構，結果發現個案有：（一）知識缺失（特定的）與對糖尿病足部護理的自我照顧有關；（二）潛在危險性損傷－跌倒與不知預防跌倒的相關訊息有關；（三）焦慮與擔心糖尿病足部傷口截肢及感染有關等三項護理問題。藉由足部護理衛教、預防跌倒措施、教導糖尿病足部自我照顧內容，結果個案學會糖尿病足部自我照顧技巧；且於護理期間未發生跌倒之意外；評估焦慮分數由61分降至31分，而緩解焦慮的問題。

關鍵字

糖尿病足部護理 ； 知識缺失 ； 潛在危險性損傷－跌倒 ； 焦慮

並列摘要

The main purpose of this paper is to describe the nursing experience of taking care of an 80-year-old male diabetic patient who was admitted to our hospital with signs of a lack of sensation in his foot. This had led to the skin becoming red and swollen with the actual loss of skin from the foot. The nursing period was between November 6 and December 4, 2006. Using the 11 items of Gordon's Functional Health Pattern Model as an assessment framework, the results showed that the patient had three nursing concerns. The first point was the general lack of knowledge related to the self-care of the patient's foot. Secondly, falling down and the patients ignorance in not knowing how to prevent it from happening are related. Finally, the concern about his amputation and infection of the foot are related. The patient was taught how to properly care for his foot in a hygienic manner, taking precautions to prevent falling down again. Our results show that the patient learned the new techniques of diabetic self-care for the foot and could apply them effectively. He never fell again during the nursing period. His evaluation score for anxiety dropped from 61 to 31 during this time.

並列關鍵字

diabetic foot care ； lack of knowledge ； self care ； falling down ； anxiety