Chang Ti-Chen, Chan Hui-Ya, Chiang Yuan-Ping
Discharge Plan Team of Nursing Department, National Taiwan University Hospital.
Hu Li Za Zhi. 2010 Apr;57(2 Suppl):S87-92.
Diabetes mellitus is a chronic disease that requires lifelong self-management. The author used a transtheoretical model to help improve the self-care abilities of one diabetes mellitus patient who lacked initial appreciation / understanding of self-care needs. During hospitalization, the author employed observation and communication to evaluate subject needs with regard to transforming her dietary behavior in order to better stabilize her medical condition. The author educated the subject on a one-to-one basis in dietary control using change tactics, and recommended that she adjust her 12 portions and food exchange. The patient was instructed to operate the blood sugar machine to monitor the effects of diet control. This method was designed to help the patient build self-care decision-making abilities during the action phase and bolster confidence during the maintenance phase through self-efficacy promotion, and to increase confidence in her self-care abilities. Telephone interview follow-ups demonstrated that the patient was able to self-comply with 12 portion rules and monitor her blood sugar on a daily basis. With blood sugar measurements at 70-105mg/dl and 110-160mg/dl, respectively, before and after meals, her diet control remained in the action phase. The patient was able to self-monitor her personal health status via blood sugar level and conduct personal healthcare maintenance work. Results support the effectiveness of applying the transtheoretical model to self-care strategies for diabetic patients.
糖尿病是一种需要终身自我管理的慢性疾病。作者运用跨理论模型,帮助一名最初对自我护理需求缺乏认识/理解的糖尿病患者提高自我护理能力。住院期间,作者通过观察和沟通来评估该患者在改变饮食行为以更好地稳定病情方面的需求。作者采用改变策略,对该患者进行一对一的饮食控制教育,并建议她调整12份饮食和食物交换。指导患者操作血糖仪以监测饮食控制的效果。该方法旨在通过提高自我效能,帮助患者在行动阶段建立自我护理决策能力,并在维持阶段增强信心,进而增强她对自我护理能力的信心。电话随访表明,患者能够自我遵守12份饮食规则并每天监测血糖。饭前和饭后血糖测量值分别为70 - 105mg/dl和110 - 160mg/dl,她的饮食控制仍处于行动阶段。患者能够通过血糖水平自我监测个人健康状况,并开展个人医疗保健维护工作。结果支持将跨理论模型应用于糖尿病患者自我护理策略的有效性。