照顧第二型糖尿病併發股骨頭膿瘍年老獨居女性之護理經驗

A Nursing Experience of an Elderly Female Living Alone with Type 2 Diabetes Mellitus Complicated with Femoral Head Abscess

本文為照顧一位老年女性因第二型糖尿病控制不佳引發左股骨頭膿瘍，接受清創手術之護理經驗。個案因自我照顧不佳而感染入院，評估案家支持系統不足，對糖尿病控制及照顧術後傷口不清楚。於2013年12月3日至12月30日護理期間，以Gordon功能性健康型態為評估工具，透過直接照護、會談等進行整體性身體評估，發現個案有營養不均衡／多於身體需要、身體活動功能障礙、無望感及家庭因應失能等健康問題。照護期間建立良好治療性關係，將飲食控制及復健運動衛教觀念導入生活，提供相關社會資源及共同擬定後續照顧計劃使順利返家。出院後持續電訪復健運動實施情形，有效讓個案調適身體不便之衝擊，增加自我控制感和適應新的生活型態。

This article described the nursing experience of an elderly female patient with type 2 diabetes mellitus, complicated with left femoral head abscess due to poor control, and was scheduled for debridement. This patient was admitted for infection resulted from self-care incapability. Further investigation indicated that the patient's family was an inadequate support system, unclear of diabetes control and post-operative wound care. From December 3 to December 30, 2013, with Gordon's 11 Functional Health Patterns serving as the framework of nursing assessment, direct care and interview were applied to evaluate the patient's health condition. The following health issues were identified: altered nutrition/more than body need, impaired physical mobility, hopelessness, and ineffective family coping. The nursing measures were to build a positive therapeutic relationship with the patient upon hospitalization, introduce diet control, rehabilitation, and health education to the patient, provide social resources after discharge, and discuss with the patient's family to develop a post-discharge care plan. Follow up telephone interviews were conducted to check up on the patient's rehabilitation status, which effectively assisted the patient in adjusting to the discomfort of the physically disability, improving sense of self-control, and adapting to the new lifestyle.