運用Orem理論照護一位糖尿病足部潰瘍患者之護理經驗

Applying Orem's Theory to the Care of a Diabetes Patient with a Foot Ulcert

本文係敘述照顧一位因第二次罹患糖尿病足部潰瘍患者行擴瘡術後之護理經驗。護理期間自民國93年4月20日至5月26日，筆者以會談、觀察方式收集資料，經由歐倫（Orem）護理理論之評估，確立個案有皮膚完整性受損、疼痛、知識不足、日常生活自我照顧能力缺失及焦慮害怕等問題。並運用歐倫護理理論之完全代償、部分代償及支持教育護理系統等概念提供個案各項護理措施；如提供個案日常生活上之照顧，維持身體上的舒適及予以心理支持。最後個案增進對糖尿病及足部自我照護之知識及能力，且順利返家。

This case report describes the application of Orem’s Self-Care Theory to the care of a diabetes patient who experienced a foot ulcer and had received debridement for a second time. During the caring period (4/20/2004 to 5/26/2004), the author used face-to-face interviews and an observational methodology to collect the data. The results found that the patient had impaired skin integrity, a defi cit of knowledge, pain, a self-care defi cit, anxiety and fear. The author used Orem’s Nursing System including the wholly compensatory system, the partially compensatory system and supportive education to provide nursing care intervention. This involved the provision of support for basic activities of daily living, the maintenance of physical comfort and the provision of mentally support. Finally, the patient showed improvement in their knowledge of diabetes and of foot care and returned home. (Tzu Chi Nursing Journal, 2007; 6:6, 127-135.)