護理師正在協助一位左側肢體無力的病人使用手杖行走。護理師觀察到下列哪項行為，顯示病人正確使用了手杖？
A nurse is assisting a client with left-sided weakness to walk with a cane. Which observation by the nurse indicates that the client is using the cane correctly?
- AThe client holds the cane in the right hand.✓ 正解病人將手杖握在右手。
- BThe client moves the cane and the right leg together.病人同時移動手杖和右腳。
- CThe client moves the right leg forward first with the cane.病人先移動右腳向前，同時配合手杖。
- DThe client leans heavily on the cane with the left hand.病人用左手大力倚靠手杖。
使用手杖的核心原則是擴大支撐面並維持重心平衡。正確做法是將手杖握在「健側」（此題為右側），即所謂的 COAL 原則（Cane Opposite Affected Leg）。當病人踏出患側腿（左腿）時，健側的手杖能同時提供支撐，分擔患側腿的重量，並模仿自然行走的對角線協調模式。若將手杖握在患側，重心會過度向左傾斜，增加跌倒風險。臨床思路應優先考慮安全與力學原理，確保病人能維持三點支撐（手杖、患側、健側）的穩定性。其他選項如先動健側腿或手杖與健側腿同動，都不符合分擔弱肢負擔的標準步態。
The core principle of cane use is to broaden the base of support and maintain balance. The correct technique is to hold the cane on the unaffected (stronger) side, which in this case is the right side, also known as the COAL principle (Cane Opposite Affected Leg). When the client advances the affected leg (the left leg), the cane on the stronger side provides simultaneous support, shares the weight of the affected leg, and mimics the natural diagonal coordination of gait. Holding the cane on the affected side shifts the center of gravity excessively to the left and increases the risk of falls. Clinical reasoning should prioritize safety and biomechanical principles to ensure the client can maintain a stable three-point base of support (cane, affected leg, unaffected leg). The other options, such as moving the unaffected leg first or moving the cane together with the unaffected leg, do not correspond to the standard gait that relieves the weak limb.
在美國，物理治療師（PT）通常負責初始評估與選具，護理師負責日常步行監督。台灣臨床則多由護理師包辦所有衛教，且家屬常誤以為手杖要拿在受傷那一邊，需更強化衛教說明。