運用健康促進生活型態模式照護一位代謝症候群個案之護理經驗

Nursing Experiences of Utilizing Model of Health Promotion in Taking Care of a Case Diagnosed with Metabolic Syndrome

代謝症候群是影響生理代謝機能之多重心血管危險因子聚集的現象，使其血脂異常、血壓偏高、血糖偏高與腹部肥胖等，並導致心血管疾病、糖尿病等慢性疾病的發生，因而增加疾病的死亡率；本文主要描述協助一位代謝症候群個案工作職場的健康促進護理經驗。護理期間於2014 年5 月1 日至11 月30 日，筆者以Pender 的健康促進生活型態模式為主軸，身、心、靈及社會為輔評估個案的生活型態，針對問題訂出護理目標，確立個案主要護理問題為健康維護能力改變、特定的健康尋求行為、營養狀況改變：多於身體所需之護理問題。於護理過程中，運用團隊照護模式，擬定系列講座、體適能課程、飲食指導、合併網路資訊之護理措施以協助個案改善健康問題，並鼓勵家屬及同事間共同參與增強個案的自我信心，且能漸進式的改變運動以及飲食習慣。經過持續半年的追蹤，個案代謝症候群的得分由4 分下降至2 分，其高血脂及痛風情形亦同步改善，希冀藉此護理經驗分享，提供護理人員重視代謝症候群的危險訊號，作為以後社區護理個案之參考。

Metabolic syndrome can influence our physical metabolism with a combination of multiple risk factors related to cardiovascular disorders. It induces dyslipidemia, high blood pressure, hyperglycemia, and abdominal obesity…, etc. The purpose of article is to describe the experiences of promoting health of a patient diagnosed with metabolic syndrome in workplace. The caring period was from May 01 to November 30, 2014. Based on Pender’s model of health promoting lifestyle and the physiological, psychological, spiritual, and social dimension of human, researcher assessed the lifestyle of the patient. Nursing problems identified included: ability to maintain health changed, specific health seeking behavior, and nutritional status changed: more than needed. Multidisciplinary care model was selected to guide the nursing care. We designed series lectures, provided physical fitness courses, instructed diet control and combined web information to help the client. We also encouraged his family and colleague to participate these strategies to reinforce the patient’s confidence and to modify his habits of exercise and diet gradually. After 6 months, the score of metabolism syndrome dropped from 4 to 2, and the status of hyperlipidemia and gout were also improved. This nursing experience could help the nursing staff to pay more attention to the risky signal of metabolism syndrome and take care of the similar clients in the community.