照顧一位第一型糖尿病青少女病患之護理經驗

Nursing Experience of Caring an Adolescent Patient with Type 1 Diabetes Mellitus

第一型糖尿病是一種無法治癒的慢性病，只能經由藥物、飲食及運動來進行控制。本文主要運用Orem理論探討一位第一型糖尿病青少女之護理經驗，護理期間為2005年10月27日至2005年11月4日，筆者以Orem理論架構評估後，發現個案有「無望感」、「不遵從糖尿病治療處置」及「家庭運作過程改變」等護理健康問題，在護理過程中，運用「以家庭為中心」的理念，以主動傾聽、關懷、支持性陪伴、同理心等技巧來建立信任關係，護理活動則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，結合家庭力量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，並促進家庭運作過程的有效性，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劃，最終使血糖獲得有效控制，期望藉此護理經驗的分享，能提供臨床護理人員照顧此類個案之參考。

Type 1 diabetes mellitus (T1 DM) is a chronic disease that is not curable. The only ways to control are through medications, dietary measures, and exercises. This case report was to explore nursing experiences of caring an adolescent patient with T1 DM. During care of this patient from October 27, 2005 to November 4, 2005, We used Orem’s theory as assessment tools and identified three nursing problems, including “hopelessness”, “noncompliance to DM treatment”, and “altered family processes”. We applied the philosophy of “family-centered care” to utilize active listening, caring, supportive accompany, and expression of empathy to establish trust relationship. The partial compensational supportive-educational nursing system was implemented to health education of DM care according to individualized needs. We incorporated families’ power into encouraging positive thinking to reinforce her self-identity and self-care ability, and also to promote effectiveness of family processes. The case finally performed insulin injection and self-monitoring blood sugar correctly. Her compliance with the intervention leads to effective control of blood sugar. This report provides nurses with a reference for caring similar patients in the future.