系統性紅斑性狼瘡病人運動照護指引之建立

Development of Exercise Care Guidelines for Patients With Systemic Lupus Erythematosus

系統性紅斑性狼瘡病人常因關節疼痛、活動程度受限，導致身體機能降低引起疲勞感。運動是一種非藥物治療，可改善肌肉功能和體適能，對病人相當的重要，本研究目的為使用實證模式發展適合紅斑性狼瘡病人之運動照護指引，提供護理人員照護紅斑性狼瘡病人運動訓練之參考。分三階段執行，第一階段進行系統性文獻搜尋發表於2003-2013年間之資料庫並擬定「紅斑狼瘡病人之運動照護指引草案」；第二階段以專家焦點團體座談，邀請台灣免疫風濕科及復健科相關專家共9人進行指引草案之效度檢定；第三階段以問卷調查臨床護理人員照護指引實施可行性，最後完成「系統性紅斑性狼瘡病人運動照護指引」，包括三個構面：護理評估6項、運動介入措施11項及評值6項，共23項，建議等級A有23項。建議未來能將運動指引推廣至各醫院，提供病人最新運動知識，並透過安全有效之運動，提昇病人活動功能及生活品質。

Systemic lupus erythematosus (SLE) patients frequently experience joint pain, which restricts their routine activities. SLE causes fatigue, which substantially reduces physical functions. Exercise is a nondrug therapy for improving muscle function and physical fi tness. Therefore, SLE patients must exercise frequently. However, no studies related to exercise care guidelines for patients have been conducted. In this study, the empirical model developed for lupus patient care guidelines for exercise was used to provide nursing care for patients conducting SLE exercise training. The exercise care guidelines were developed in 3 phases. In the first phase, a systematic literature review was conducted to examine the 2003-2013 database. In the second phase, an expert focus group was organized. Nine rheumatism and rehabilitative medical experts were invited to assess the validity of the draft guidelines. In the third phase, a questionnaire survey was conducted to assess the feasibility of implementing the proposed guidelines into the nursing staff guidelines and thereby achieve the fi nal version, 'systemic erythematosus lupus patient exercise care guidelines.' The guidelines contained 3 dimensions and 23 items, including 6 items for nursing assessments, 11 items for exercising intervention, and 6 items for evaluation. The results indicated that all 23 items were recommended as grade A. We suggest that the proposed exercise guidelines be installed in the hospitals to provide patients with updated exercise knowledge and enhance physical function and quality of life through safe and effective exercise.