運用Watson關懷理論協助一位糖尿病血液透析個案面對足部潰瘍之護理經驗

Nursing Care Experience for Foot Ulcer in a Diabetes Hemodialysis Patient to Applying Watson's Theory

10.6204/JRSHP.2015.07.05

黃璿璇；洪錦墩；何清治

糖尿病 ； 血液透析 ； 足部潰瘍 ； Watson關懷理論 ； Diabetes Mellitus ； Hemodialysis ； foot ulcer ； Watson's Theory

休閒運動保健學報

9期（2015 / 07 / 01）

55 - 68

繁體中文

筆者擔任門診護理師，運用Watson關懷理論為基礎，探討一位中年男性病人罹患第二型糖尿病，長期接受血液透析治療，個案又因糖尿病足部傷口慢性潰瘍、癒合不良，導致右足第2至5腳趾嚴重缺血及壞疽，使其反覆住院接受清創與腳趾截肢手術。於門診換藥時，個案顯得神情落漠、沉默不語，也不願意看傷口的負向行為表現，引發筆者思考進行此研究動機。本研究的目的是為了增進個案復原力及達到部分自我照顧能力，提升個案居家生活品質及減少再度入院情形，期望藉由護理此個案之經驗分享，能提供臨床護理人員照護類似個案之參考，以增進臨床照護之品質。

The author is a nurse in out-patient clinic who used Watson's Theory as a foundation to discuss a middle-aged male patient contracting Diabetes Mellitus II and receiving long-term hemodialysis treatment. Because of this disease, the patient had a chronic foot ulcer and could not heal. So a lack of blood and gangrene happened from his second to fifth toes on the right foot. He needed to be hospitalized repeatedly and receive debridement and toe amputation. The patient's depression, silence and unwillingness to see his wound gave the author a motivation to study these negative behaviors. This study aims to improve the patient's recovery, self-care ability and living quality and reduce the frequency of hospitalization. Moreover, with the nursing care experience for this case, it gives clinical nursing staff advice to improve the nursing quality.