一位糖尿病併發壞死性筋膜炎病患之照護經驗

A Nursing Experience of a Diabetes Mellitus Patient Complicated with Necrotizing Fasciitis

本文探討一位糖尿病併發壞死性筋膜炎病患的護理經驗。照護期間為2014年7月15日至8月28日，運用Gordon十一項健康功能型態評估及實際照護進行資料收集，確立病患有急性疼痛、焦慮、組織完整性受損、知識缺失等健康問題。護理期間提早介入良好的護病關係，提供專業護理衛教，運用轉移及音樂療法緩解疼痛，但病患擔心併發症日趨嚴重需要反覆手術，引發焦慮失衡，透過跨領域團隊合作，以教育病患自我照護技能，正視疾病帶來的威脅緩解焦慮，進而提升睡眠，期望藉此照護經驗分享，更加確立護理衛教的重要性。

This article discusses a nursing experience of a diabetes mellitus patient complicated with necrotizing fasciitis. The nursing period lasted from July 15th to August 28th, 2014. With Gordon's 11 functional health patterns as an assessment framework data were collected by direct nursing. The patient was identified with acute pain, anxiety, impaired tissue integrity, and knowledge deficit. Through early nursing interventions, a nursing-patient rapport was established, professional health care provided, and distraction and music therapy employed to alleviate pain. However, the patient's fear of repeated surgery as the complication worsened caused anxiety imbalance. With interdisciplinary cooperation, the patient was taught selfcare skills, and to relief anxiety by facing the threat of the disease, which then enhances the quality of sleep. We hope that by sharing this nursing experience to consolidate the importance of nursing health education.