- 期刊
照護一位門診初次罹患第二型糖尿病肥胖患者之護理經驗
The Nursing Experience of Caring for an Obese Patient with Newly Diagnosed Type 2 Diabetes in an Outpatient Clinic
摘要
本文為照護一位門診罹患第二型糖尿病患者，初次被診斷糖尿病造成心理衝擊，因肥胖及血糖控制不佳而收案，且評估個案對疾病的自我管理與照護動機薄弱，面臨需自行學習胰島素注射治療感到困擾，究其原因在於知識不足及缺乏健康行為，護理期間為2020年1月8日至5月6日，藉由觀察、評估、會談、病歷查閱等方式執行個案管理照護，運用Gordon十一項功能性健康型態進行評估，收集主、客觀資料及確認健康問題，發現個案有（一）知識缺失、（二）焦慮、（三）營養不均衡：多於身體需要、（四）靜態生活型態等健康問題。照顧期間與跨領域醫療團隊共同介入，與個案擬定相關護理計畫，除了教導糖尿病正確知識外，並將飲食控制及運動訓練衛教觀念導入生活，教導自我管理照顧技巧及給予心理支持，並運用醫病共享決策的輔助及衛教平台，可增加個案更好的醫療遵從性，個案也會主動參與疾病管理的決策，增加個案自我照顧的責任與能力，另將個案轉介三高個管師，銜接慢性病追蹤照顧，為具體可行之建議，以降低糖尿病併發症風險，得到較佳照護品質。
並列摘要
This article is about caring for a patient with type 2 diabetes in an outpatient clinic. The newly diagnosed type 2 diabetes mellitus caused patient's psychological shock. Due to obesity and poor blood sugar control, poor self-management of the disease and weak motivation for caring were noted. He was troubled by the need to learn insulin injection treatment by himself because of the lack of knowledge and healthy behaviors. The nursing period was from January 8 to May 6, 2020. Case management and care were performed through observation, evaluation, interview, and medical record review. The Gordon's eleven functional assessment was to assess health status by collecting subjective and objective information and confirmation of nursing problems. We found that the patient had (1) deficient knowledge/lack of correct knowledge about diabetes (2) anxiety/ nervous about insulin injection technique (3) imbalanced nutrition: more than the body needs/personal diet imbalance (4) sedentary lifestyle /lack of exercise. During the period of care, we cooperated with the multi-disciplinary medical team and formulated relevant care plans with the patient. In addition to teaching the knowledge of diabetes, we also introduced the concepts of diet control, exercise training, and health education into patient's life, educated the patient self-management and care skills, and provided psychological support. What was more, we applied the shared decision-making model with psychoeducation platform to facilitate the patient's responsibility and medical adherence. Finally, the patient was referred to the case manager of chronic diseases to link with the chronic disease follow-up care. The above strategies are specific and feasible in reducing the risk of diabetic complications and improving care quality.
參考文獻
延伸閱讀
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