一位糖尿病患者接受截肢術後之護理經驗

Nursing Experience of a Patient with Diabetic after Amputation

本文描述一位糖尿病足截肢病患之照護經驗。筆者於2011年1月11日至2月4日照護期間，運用Gordon十一項健康功能型態進行評估，並藉由直接護理、觀察會談、資料收集及追蹤訪談等方式，收集主、客觀資料並加以分析整理。確立個案有疼痛、自我照顧能力缺失、身體心像紊亂及危險性感染等護理問題，並針對上述護理問題提供個別性、整體性之護理計畫與措施，包括藉由肌肉按摩、深呼吸放鬆及轉移注意力等技巧以緩解疼痛；經由提供完整傷口照護以促進傷口癒合；並以傾聽、關懷、同理與接納之態度，教導個案自我照顧並引導家屬共同參與照護活動，使其漸漸能正向接受身體結構功能的改變，進而學習使用助行器步行，開始嘗試面對截肢後生活。期望藉由分享此護理經驗，能提供日後護理同仁照顧類似病患之參考。

This article described the nursing experience of caring a patient with diabetes-related limb amputation. During the nursing period from January 11 to February 4, 2011, the author evaluated his health problems by Gordon’s 11-item functional health pattern and analysis via direct nursing care, observation and a variety of interactive interviewing skills. According to the results of data analysis, major problems encountered by nurses included acute pain, self-care deficit, disturbance body image, and risk of infection. According to his problems, we rendered complete measures to relief of pain, wound healing, acceptance of altered body image, independence in self-care, co-operation with family and restoration of physical mobility in advance. Eventually, the patient will accept his body image after amputation.