運用跨理論改變一位代謝症候群個案健康行為之護理經驗

Nursing Experience of Applying the Transtheoretical Model to Change the Health Behavior of a Patient with Metabolic Syndrome

本文運用跨理論模式協助一位健診42歲代謝症候群個案建立行為改變之護理經驗。照護期間從2020年5月2日至2020年12月15日，筆者藉由觀察、會談、電訪及郵件收集資料，採Gordon十一項健康功能模式型態及跨理論模式，確立個案主要問題為無效性健康維護、特定健康尋求行為，於護理過程中筆者以跨理論模式為主軸，並依據個案為中心之行為改變階段，運用改變策略，訂定出護理目標。照護期間以情感喚起、意識覺醒、增強管理、助人的人際關係、反制約等護理措施，協助個案改變行為，並可自行安排及紀錄運動、飲食、血壓與血糖自我監測計畫之過程，自行調整運動頻率與強度，依循飲食計畫適量攝取均衡飲食，以達成行為維持期目標。期望藉由此個案報告，喚起護理人員對於健康促進議題的敏感度，並運用跨理論模式評估及協助個案擁有更健康的生活型態。

This paper describes the application of the Transtheoretical Model (TTM) to facilitate behavior change in a 42-year-old individual with metabolic syndrome. From May 2, 2020, to December 15, 2020, data was collected through observation, interviews, telephone interviews, and email. Using Gordon's Eleven Health Function Model and the TTM, the primary issues identified were ineffective health maintenance and inadequate health-seeking behaviors. The TTM was employed as the core framework to guide the nursing process, with strategies tailored to the client's stage of behavior change. Nursing interventions, including emotional arousal, consciousness-raising, self-management enhancement, interpersonal support, and counterconditioning, were used to promote behavior modification. The client was able to establish and record exercise, diet, and self-monitoring plans for blood pressure and blood glucose, adjust exercise frequency and intensity, and follow a balanced diet plan, ultimately achieving the goal of maintaining healthy behaviors. This case report aims to increase nurses' awareness of health promotion issues and demonstrate the effective use of the TTM in assessing and assisting individuals in adopting healthier lifestyles.