運用行為改變跨理論模式協助一位第2型糖尿病患者運動促進之護理經驗

An Experience Using the Transtheoretical Model of Health Behavior Change to Promote Exercise in a Type 2 Diabetes Patient

本篇個案報告在於分享運用行為改變跨理論模式，協助一位第二型糖尿病患運動促進的經驗。照護期間為民國95年5月至7月，藉由觀察及會談收集資料，經二次門診及五次電話訪視，結果分析顯示個案正處於行為改變之準備期階段；筆者藉由運用自我再評價、自我承諾、增強管理、自我改變計畫擬定、找出社會支持力量及環境線索的佈置等策略；經由上述的護理介入措施後，以促進個案執行規律運動的措施，進入行動期階段，個案能主動記錄運動日誌，擬訂及執行運動計畫，並逐日增加運動頻率及強度，協同家人一起執行規律運動。筆者期望藉此個案報告，能提供醫護人員以行為改變跨理論模式照護此類個案之參考。

This case report shares our experience using the transtheoretical model of health behavior change to promote exercise in a type 2 diabetes patient. The patient was under our care from May through July 2006, during which time the patient was under regular observation and interviewed to collect data. A total of two outpatient consultations and five telephone interviews were conducted. An analysis of results showed the subject to be in the preparation stage of behavior change. To help move the subject into the action stage, the author promoted regular exercise through a variety of strategies, including self-reevaluation, self-change plan development, self-liberation, contingency management, social support search and environmental reevaluation. After nursing intervention, the subject maintained an exercise journal and arranged his own exercise plan. His exercise regimen gradually increased the frequency and intensity of exercise and further extended the scope of exercise to include regular exercise with family members. The author hopes that this case report may provide a reference for health professionals on the use of the transtheoretical model of health behavior change in the care of this type of patient.