照顧一位初次診斷第一型糖尿病青少年之護理經驗

Nursing Experience of Caring for an Adolescent Patient Newly Diagnosed with Type 1 Diabetic

楊桂芳(Kuei Fung Yang)

第一型糖尿病 ； Orem自我照顧理論 ； 青少年 ； type 1 diabetic ； Orem's Self-Care Theory ； adolescent

嘉基護理

20卷2期（2020 / 12 / 01）

30 - 39

繁體中文

第一型糖尿病是一種無法治癒的慢性病，只能經由藥物、飲食與運動來進行控制；本文為照顧一位初次診斷第一型糖尿病青少年學習自我照顧之護理經驗，護理期間為2019年12月26日～2019年12月30日，筆者以主動傾聽、關懷、支持性陪伴、同理心等技巧建立信任關係，並採Orem自我照顧理論進行身、心、社會及靈性等層面資料收集，經護理評估分析後發現個案的主要問題有「健康維護能力改變」、「不遵從」、「無望感」等健康問題。護理過程中，視個別性需要由部分代償性護理系統進入支持教育性護理系統，適時提供糖尿病衛教介入措施，鼓勵個案朝向正向思考，以強化其自我認同感與自我照顧能力，使個案能正確執行注射胰島素及自我監測血糖，且遵循糖尿病飲食計畫，最終使血糖獲得有效控制。建議針對此類病人應常規協助連絡糖尿病衛教中心提供關懷支持與衛教介入，並增設「青少年糖尿病衛教師」，提升照護品質。期望藉此護理經驗分享，提供臨床護理人員照護之參考。

Type 1 diabetic is an incurable chronic disease controllable through the use of medication, diet, and exercise. This paper describes the author's nursing experience of helping an adolescent patient, newly diagnosed with type 1 diabetic, practice self-care between December 26-30, 2019. The author with the patient by listening, caring, providing supportive company, and showing empathy. The author also employed Orem's Self-Care Theory in collecting data relating to the physical, psychological, social, and spiritual aspects of the patient. Through a nursing assessment, the patient's major problems were identified to be changes in self-care capabilities, noncompliance, and feelings of hopelessness. Based on individual needs, the partly compensatory nursing system was integrated with the supportive educative nursing system during the nursing process. Diabetes education and intervention measures were also employed to encourage a positive mindset in the patient, so as to strengthen the patient's sense of self and self-care capabilities. This allowed the patient to properly administer insulin, monitor blood glucose, and follow a diabetic diet plan, thus achieving effective control of blood glucose. It is recommended that this type of patient be assisted by diabetic education centers, which can provide support, care, education, and intervention. Adolescent diabetic educators can also be employed to improve healthcare quality. The author hopes to provide this nursing experience as a reference for nursing care to clinical nursing personnel.

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