- 期刊
應用Orem的自我照顧理論於一位多次酮酸中毒青春期少女之照護
The Application of Orem's Self-care Theory on a Teenage Female Patient with Multiple Ketoacidosis
摘要
本文為一位多次酮酸中毒之第一型糖尿病青春期少女，學習自我照顧，進而控制血糖的護理經驗。於2015年8月26日至9月4日實際護理期間，藉由住院直接照顧、觀察、會談及電話訪談方式收集資料，運用Orem's自我照顧理論確立個案的三項護理問題為：潛在危險性傷害／與血糖不穩有關、知識缺失／與糖尿病飲食選擇及代換知識不足有關及不遵從糖尿病治療／與負向自我認同有關。照顧過程中，尊重其青春期特質，協助正向接受疾病，給予疾病認知及自我照顧指導，並連繫家長與學校老師建立支持環境，正向增強同儕支持，強化良好的自我照顧行為，增進對糖尿病控制的自信及能力，希望藉由此護理經驗，分享給護理同仁，以提供日後照顧此類個案的參考。
並列摘要
This article is about a nursing experience in a teenage girl with Type 1 diabetic who suffered several times of ketotic acidosis (DKA). We taught her how to take care of herself and control her blood sugar. The data was collected through direct care of the patient, observation, an interview, and a telephone interview during her admission from August 26 to September 4, 2015. Three nursing problems were identified: injury risk of blood sugar instability, knowledge deficits related to diabetic diet choices, and noncompliance of diabetic treatment due to negative self-identity. During the care process, Orem's self-care theory was used. We also monitored the variability of blood sugar and developed an individualized exercise plan. Our nutritionist developed a dietary plan and ensured she had a complete understanding of diet preparation as well as substitution. We helped the patient increase her awareness of type 1 diabetes and face her disease positively. We also contacted the parents and school teachers to build a supportive environment. This could positively increase her peers' support and strengthen her self-care behaviors. As a result, she will have more confidence and ability regarding diabetic control. We hope that by sharing this nursing experience, our fellow colleagues will have some references of caring for this kind of patient in the future.