運用Orem理論協助高血壓患者自我照顧之護理經驗

Applying Orem´s Theory to the Care of a Hypertension Patient Undertaking Self Care

本文旨在描寫一位高血壓患者護理經驗。照護期間為96年11月15日至12月21日，以門診會談及觀察收集資料，經由歐倫（Orem）護理理論之評估及運用疾病個管護理模式，確立個案有『知識缺失』、『不遵從飲酒控制』及『焦慮』等問題。以完全代償、部份代償及支持教育護理等概念提供護理措施，如：依個案個別性衛教手冊，提升疾病認知；擬定『逐漸減少飲酒量計畫表』及『飲酒日記報告』；傾聽自覺感受予心理支持舒緩其焦慮，增進高血壓及飲酒控制知識及能力，使飲酒習慣改善血壓獲得良好控制。期望此經驗能提供護理人員照護類似個案之參考。

This case report describes the application of Orem's Self-Care Theory and disease management intervention to the care of a hypertension patent. During the caring period (11/15/2007 to 12/21/2007), the author used face-to-face interviews and observation to collect the data. The results showed that the patient had a knowledge deficit, poor control of alcohol consumption, anxiety and fear. The author used Orem's Nursing System, including the wholly compensatory system, the partially compensatory system and supportive education, to provide a number of nursing care interventions. These consisted of making an individualized brochure of health education to promote knowledge of the disease, setting up an 'abatement schedule for alcohol consumption', creating a 'daily report of alcohol consumption', relieving the patient's anxiety by listening and providing mental support, enhancing the patient's knowledge about and ability to control their hypertension and alcohol consumption. The overall aim was to improve the patient's drinking habit and maintain their blood pressure in an appropriate range. The author hopes that this case report may provide a reference for health professionals who are taking care of this type of patient.