骨質疏鬆病人之實證護理－－以設計運動介入方案為例

Designing Exercise Protocol for Patients with Osteoporosis: An Evidence-Based Nursing Approach

實證護理的精神是將研究證據與專業判斷做整合而提供有效的措施；護理人員要應用最好的研究證據，整合病人資料及臨床觀察而下最佳的介斷；其有助臨床判斷能力及病人照護品資之提升。骨質疏鬆之老化的重要症狀之一，早期處理而延緩或預防骨質流失，以提供高品質生活是照護目標。查證一系列運動與骨骼相關之研究，得知運動是預防此症之要素。對骨質疏鬆患者執行運動介入性研究時，運動處方是頗重要的，內容包括運動類型、部位、強度、頻率及持續時間，設計可在家中實行的安全又有效之運動方間。設計可在家中實行的安全又有效之運動方案，改善身體的肌力、柔軟度、平衡感、及協調性，以降低跌到的危險性，也能阻止骨質疏鬆現象的骨密度惡化，進而提昇健康生活品質。

Evidence-based nursing (EBN) is the integration of professional judgment and research evidence about the effectiveness of interventions. Nurses make the best clinical decisions by reviewing the best research evidence and integrating client data from clinical observation. EBN can promote not only nurses' critical appraisal skills and ability of clinical judgment, but also the quality of health care. This paper reviews the state of the science of interventions using exercise to decrease the bone mass loss of elderly persons. Osteoporosis has a high prevalence among elderly persons. In order to promote their quality of life, finding ways to prevent or postpone bone mass loss by early intervention is the nursing goal for this group. From the literature, regular exercise is an essential part of osteoporosis prevention. The exercise protocol includes exercise mode, area of body, intensity, frequency and duration, which is an important part of exercise intervention for osteoporotic person. Designing a safe and effective exercise protocol that can be implemented at home is very practical. The major effect of exercise is to improve muscle strength, flexibility, balance and coordination, thereby reducing the risk of falling, slowing the progression of osteoporosis and promoting quality of life.