協助一位第二型糖尿病中年男性自我管理之護理經驗

The nursing experience to apply self-management education in a male with type 2 diabetes mellitus

劉紅瓊(Hung-Chiung Liu) ； 宋聖芬(Sheng-Fen Sung)

《安泰醫護雜誌》 25卷2期 (2019/12) Pp. 63-77

摘要

此本文描述一位62歲中年男性居無定所到處演出布袋戲，原以為是工作疲勞、頭暈所產生身體不適，竟料是第二型糖尿病所引起的高血糖高滲透壓狀態（HHS）感到無能為力。護理期間自2017年7月31日至8月4日，出院後持續電訪並回診關懷至2017年8月11日。運用觀察及會談及電訪方式收集資料，經由Gordon十一項功能性健康型態評估，確立問題包括現存性傷害、無力感、糖尿病自我照顧認知不足及營養不均衡，故運用糖尿病自我管理教育技巧以增進血糖管理、自我照顧認知、正確營養素攝取等外，同時運用同理心技巧，與個案建立治療性人際關係，讓個案能克服內心對於疾病的無力感進而學習與病共存，幫助個案回歸良好生活型態，以提升糖尿病自我管理行為，故藉此護理經驗予醫護同仁分享，作為日後照護上之參考。

關鍵字

第二型糖尿病 ； 糖尿病自我管理教育 ； 無力感

並列摘要

This case report describes a 62-year-old male , who is a hand puppet master and travels for the show. The patient suffered from long-term fatigue and dizziness, but he considered these as overwork symptoms. However, it was type II diabetes complicated with hyperosmolar hyperglycemic state (HHS) related. The patient was admitted during July 31 to August 4 ,2017, followed by a post-discharge follow-up phone call program until August 11, 2017. For this case, we applied approaches such as observation, interview and phone calls to collect data, and a comprehensive assessment model (Gordon’s 11 Functional Health Patterns) to determine the patient's problems (including the existing damages, the frustration , the lack of self-care for diabetes, and the imbalance of nutrition levels). By adopting educational techniques of diabetes self-management, the patient is expected to improve his glycemic control, the awareness of self-care, and proper nutrient consumption. Moreover, we also adopt empathy techniques to help the case establish confident interpersonal relationships, so he can overcome the frustration toward his disease, learn to live with the disease, and eventually return to a good lifestyle with adequate self-management for his diabetes. This case report is for nursing colleagues' future references while caring patients with similar conditions.

並列關鍵字

type II diabetes ； Diabetes self - management education ； powerlessness