照護一位初次罹患第一型糖尿病之學齡期兒童的護理經驗

Experience of Caring for a School-aged Child Newly Diagnosed with Type 1 Diabetes

李靜宜(Jing-Yi Li) ； 王卿凌(Ching-Ling Wang) ； 李詩敏(Shih-Min Li) ； 陳紀雯(Chi-Wen Chen)

《榮總護理》 32卷4期 (2015/12) Pp. 366-373

https://doi.org/10.6142/VGHN.32.4.366

摘要

本文主旨在描述一位因體重減輕、高血糖症狀而入院，初次診斷罹患第一型糖尿病之學齡期兒童的護理經驗。照護期間為2013年10月22至25日，筆者運用Gordon十一項功能型態進行整體性身體評估。在護理過程中，配合醫療處置，透過觀察及會談，進行資料收集及分析，確立個案主要的健康問題有特定的知識缺失、現存性不穩定血糖濃度疾病及照顧者角色緊張。因初次診斷罹病，個案及家屬對疾病照護不了解，所以顯得焦慮及不安，但筆者藉由持續主動關心個案，與家屬建立信任的護病關係，運用同理心，傾聽及陪伴，從中發現個案的健康問題，給予適切的護理措施，幫助個案及其主要照顧者學會第一型糖尿病相關之照護知識與技能，並提供相關資訊及支持團體以緩解焦慮不適感，透過糖尿病個管師及營養師共同協助指導個案及家屬，進而促進個案之疾病控制與健康維護。期盼此篇護理經驗，用於幫助日後照護類似個案之參考。

關鍵字

第一型糖尿病 ； 學齡期 ； 護理

並列摘要

This article describes the experience of caring for a school-aged child newly diagnosed with Type 1 diabetes, who was admitted to the hospital because of body weight loss and hyperglycemia. Nursing care was provided from October 22 to 25, 2013. The authors used the Gordon 11 Function Health Patterns during the treatment to assess the health status of the patient. The medical treatment was designed and the health history was obtained through observation and an interview, and the health data collected were analyzed, revealing that the major problems of the case were self-care deficit, glycemia, knowledge deficit, and caregiver role strain. Being newly diagnosed with Type 1 diabetes, the patient as well as the family members, lacked a suffi cient understanding regarding medical treatment, which caused anxiety and agitation. The authors showed great initiative in caring for and empathizing with the patient to build trust in nurse- patient relationships. The authors discovered the health problems of the patient by attentively listening to and accompanying the patient, and nursing interventions were subsequently delivered in a comforting manner. In addition, the authors helped the patient and particularly the main caregiver in learning how to provide proper physical care and served as communicators between the patient and the health care team. Moreover, the authors provided relevant information and a support group for discussing anxiety and agitation. With the cooperation of a diabetes case manager and nutritionist, the patient and family members were assisted. Thus, the health problems of the patient were controlled and health care was maintained. The authors believe that this nursing experience can be used as a reference for future caring cases.

並列關鍵字

type 1 diabetes ； school-age ； nursing

參考文獻

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