運用歐倫理論於一位糖尿病患者截肢後之護理經驗

The Nursing Experience Applying Orem Theory to a Diabetes Patient with Amputation

本文旨在探討一位48歲中年男性，因糖尿病知識不足而造成截肢前後的行為反應，不僅影響個人身、心健康，也間接造成生活品質受影響，護理期間為2011年08月15日至25日，以歐倫自我照顧理論作為評估依據，藉由直接護理、觀察、會談、身體評估及電話追蹤訪談等方式收集資料，運用傾聽及主動關懷方式讓個案說出心中感受，確立個案主要護理問題有身體心像紊亂、焦慮、知識缺失等。護理期間教導個案有關殘肢的照護及義肢使用以維持其生活基本功能，增進有關糖尿病注意須知及足部自我照顧之知識，在返家後則建議照顧類似個案應增加出院準備服務的介入，延長追蹤時間可了解職場及生活上的調適情形，適時給予協助或諮詢，協助個案調整生活，提高生活品質。

This paper describes a 48-year-old patient's behaviors pre- and post- amputation surgery that impacted the patient's health directly in physical and psychological aspects and indirectly in quality of life. The nursing period was from August 15 to 25, 2011. The author assessed the patient's care needs using the Orem Self-Care Theory. Data were collected through a face-to-face interview, direct observation during patient care, and a telephone follow up. The patient was able to share his feelings with the nurse, who demonstrated attentive listening and caring. The identified nursing problems included disturbed body image, anxiety, and a deficit of knowledge. The patient was taught about care for the limb stump and the use of prosthetics in maintaining basic functions for daily life. The patient learned about diabetes care with a focus on self-care for limb health. The author also suggested discharge preparation for similar cases and an extension of post-discharge follow-up to better guage thepatients' adaptation to daily activities and work. With adequate assistance and consultation, amputee patients may adapt to their new life with prosthetics and improve their quality of life.