照護一位糖尿病足部病變老年患者之護理經驗

Nursing Experience of Caring for an Aging Patient with Diabetes Mellitus and Feet Lesions

本文描述一位糖尿病足部病變老年患者的護理經驗，筆者於2017年8月21日至10月8日，運用Gordon十一項健康功能性型態評估，藉由觀察、會談、身體評估等方式進行資料收集，確立護理問題：疼痛、知識缺失（特定於胰島素注射）、焦慮。護理過程中教導按摩雙腳減緩病人疼痛，介紹成功案例分享正向想法，減輕病人焦慮，利用「糖尿病看圖對話地圖」強化病人糖尿病相關知識，在胰島素注射筆劑量顯示區使用鮮豔紅色標記，由案孫示範胰島素注射過程並拍成影片，讓病人能反覆觀看，解決病人因老年視力及記憶退化無法正確注射胰島素劑量的問題，建議醫護人員可運用多元化衛教方式促進老年病人健康行為，希望藉此經驗提供照護此類病人之參考。

This case report is on the nursing experience of caring for an elderly male patient with diabetic foot lesions. The author assessed the patient's health condition through observations, interviews, physical examinations, and the use of Gordon's functional health assessment guidelines between August 21^(st) and October 8^(th), 2017. His nursing diagnosis was defined as pain, a lack of knowledge (especially about insulin injections), and anxiety. We performed foot massage to reduce his pain and shared successful experiences of positive thinking to relieve his anxiety. The patient also had presbyopia, which we addressed using conversation map education tools and drawing a bright red mark on his insulin device's dose display area. In addition, to address his memory loss, we created a video of his grandchild for when he performed the insulin injection procedure correctly. We strongly recommend that in the future, medical staff provide multiple health education tools for elderly patients to promote their health behaviors.