運用自我效能於一位初次罹患第二型糖尿病門診病患護理經驗

An Experience use Self-efficacy in Caring for a Newly Diagnosed Diabetes Mellitus Type Ⅱ Outpatient

郭麗琴(Li-Chin Kuo) ； 楊星瑜(Hsing-Yu Yang)

《東港安泰醫護雜誌》 11卷1期 (2005/03) Pp. 49-59

https://doi.org/10.7078/TSMHMNJ.200503.0049

摘要

糖尿病是位居國人死亡率第五名的慢性疾病，良好的自我照顧可以有效的控制血糖值，降低糖尿病帶來的合併症。本文是運用Ootim學者之自我效能模式，來護理一位初次罹患第二型糖尿病的門診病患，在過程中藉由Gorden的十一項功能性健康評估，發現病患因疾病認知不正確再加上未能確實執行相關血糖控制措施而產生無力感、因未能有規律性運動行為的養成而致個人治療計畫處置不當、因環境因素如主要飲食調製者-母親不知個案罹患糖尿病及工作環境以外食居多而致不遵從飲食建議等問題，而造成血糖控制不良的護理問題。護理期間運用增強自我效能來源四項措施：先以接納的態度引發個案抒發情緒；透過言語說服增強個案相信自己能成功地面對此一疾病；當個案執行健康照護行為或是進而產生好的結果時，如每日自我監測血糖、飲食選擇改變等，到最後HbA1C降低時，除不斷地讚賞其行為表現結果外，並將最後血糖的下降與其行為執行作關聯以增強其行為執行的持續性；另外提供其他個案的替代性經驗讓個案了解養成規律性運動及飲食控制等行為，可不需依賴藥物而達到良好的血糖控制，以增強個案行為改變的動力。最後個案在其健康行為改變與養成後，血糖能維持100-120mg/dl、HbA1C下降至7.5%。

關鍵字

自我效能 ； 第二型糖尿病

並列摘要

Dibetes Mellitus (DM) is a chronic disease, and has been the fifth of the ten leading causes of death, Good self care can helps clients with DM controlling their sugar level and reducing complications. This study uses the Self-efficacy model which was develoved by Ootim for a newly Diabetes Mellitus Type Ⅱ outpatient. By using Gordon health assessment quide the author identified the patient's health problems were as follows: powerlessness, ineffective management of therapeutic regimen, non compliance of dietary regimen. These health problems cause his blood sugar being poor control. Nursing interventions were based on used the four sources of self-efficacy: Set self sugar monitoring, exercise and diet control the phased goal to stipulate. In addition, use performance accomplish,. verbal persuasion to improve oneself's efficacy of looking after behavior to expect, increase the case to cognition of the disease were used the relative's support strength and improve the action strength that the case carry out the sport and diet and control, reach the effective blood sugar is controlled and to look out self-care after the behavior to change healthily.

並列關鍵字

Self-efficacy ； Diabetes Mellitus Type Ⅱ