一位酗酒個案初次罹患第二型糖尿病之護理經驗

Nursing experience in an alcoholic case with newly diagnose diabetes type 2

10.6647/CN.24.03.14

蘇家慧(Su-Chia Hui)；鍾玉珠(Yu-Chu Chung)

第二型糖尿病 ； 營養不均衡 ； 無效性健康維護能力 ； 無力感 ； Diabetes type 2 ； imbalanced nutrition ； ineffective health maintenance ； powerlessness

彰化護理

24卷3期（2017 / 09 / 01）

106 - 117

繁體中文

本文旨在探討一位酗酒個案初次罹患第二型糖尿病之護理經驗。護理期間自2016年08月12日至2016年08月19日，透過觀察、會談、身體評估及查閱病歷方式收集資料，進行生理、心理、社會、發展及靈性評估，確立個案主要的護理問題為營養不均衡：少於身體需要、無效性健康維護能力及無力感。護理過程中首先運用主動關懷、同理心、傾聽及陪伴技巧，與個案建立良好的護病關係，轉介戒酒門診及提供衛教有關長期喝酒對血糖控制及營養所造成之影響，以及會診營養師透過飲食衛教及飲食代換原則，逐漸改善個案體重不足問題。其次提供個別性的照護，教導血糖控制措施及自我監測血糖技巧，增強個案對疾病的認知及提升其自我照顧知識與技能，達到穩定的血糖控制。同時透過病友經驗分享及協助家庭支持系統之運作，降低個案對疾病的焦慮，提升自我控制感及自我控制信心，最後個案能以正向態度面對糖尿病所帶來的生活改變與疾病共存。期望能藉由本文照護經驗提供護理人員在照顧此類病患時之參酌。

This article aims to explore the nursing experience in an alcoholic case with newly diagnosed diabetes type 2. The nursing period was from August 12th to 19th, 2016. The author collected data through interview, observation, physical examination, and medical record review. With an assessment of the patient's care needs in physical, emotional, social, spiritual and developmental aspects, the identified major care problems were imbalanced nutrition: less than body requirement s, ineffective health maintenance, and powerlessness. To establish a good relationship with the case, I initially applied active caring, empathy, listening and accompany skill. I also referred this case to outpatient clinic of abstinence from alcohol, and provide health education about the impact of long-term alcohol drinking on blood sugar control and nutrition, and consultation of nutritionists through diet education and diet substitution principle, and gradually improve the problem of underweight. To reach a stable blood sugar control, I taught him blood sugar control measures, self-monitoring blood sugar skills to enhance his disease awareness and his own care individually. I hope that I could reduce his anxiety of the disease, enhance self-control capacity and confidence of self-control through other diabetic patient sharing and family support system. He would have positive mind facing the changes of life and lived with the disease. This nursing experience is shared with nurses taking care of patients with a similar condition.

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