運用實證等長深蹲運動於一位高血壓病人之照護

Applying Evidence-Based Nursing of Isometric Wall Squat Exercise on a Patient with Hypertension

本文描述一位57歲男性，診斷第一期高血壓病人，無系統性疾病。此次因運動後易呼吸喘且胸悶不適入院詳細檢查。照護期間（2022年4月6日至5月6日）運用四大層面護理評估，確立個案有活動無耐力、焦慮與高血壓患者返家照護事項之知識缺失之護理問題。基於篇幅所限，筆者僅針對活動無耐力運用實證護理探討等長深蹲運動能否有效控制血壓；搜尋英文實證文獻，最後萃取2篇支持等長深蹲運動介入高血壓患者血壓有效控制之文章，持續4週每週3次之等長深蹲運動（1次包括4回合，每回合維持2分鐘），4週後患者紀錄的收縮血壓平均值從135 mmHg降為128 mmHg、舒張血壓平均值從80 mmHg降為75 mmHg，且胸悶不適、運動後容易呼吸喘情形已改善。個案結果支持等長深蹲運動可有效控制血壓值並增加活動耐受能力。期望藉此實證照護經驗，提供醫護人員針對高血壓患者的臨床照護需求。

The subject of this study was a 57 years old male patient diagnosed with stage 1 hypertension and no systemic disorders who was admitted for detailed evaluation due to the onset of exertional dyspnea and chest tightness after exercising. The author utilized four dimensions of nursing assessment for analysis and identified nursing issues during the patient's hospital period (from April 6 to May 6, 2022), such as activity intolerance, anxiety, and knowledge gaps. To comply with the manuscript length restrictions, the author only targeted the nursing problem of activity intolerance and investigated the possibility of employing an isometric wall squat exercise to improve blood pressure control in patients with hypertension using an evidence-based approach. Two studies that demonstrated improved blood pressure control with isometric wall squat exercises (3 times per week for 4 weeks) in hypertensive individuals were chosen and evaluated for thoroughness and quality using the CASP technique. The average systolic blood pressure dropped from 135 to 128 mmHg after exercise training for 4 weeks, and the average diastolic blood pressure dropped from 80 to 75 mmHg. Furthermore, there were no longer any reports of chest pain, and the exertional dyspnea brought on by activity had subsided. With the help of this evidence-based nursing experience, medical professionals may be able to better satisfy the clinical care demands of hypertension patients.