護理師正在指導一位行動不便的病人如何使用助行杖。下列哪項指導說明是正確的？
A nurse is teaching a client with limited mobility how to use a cane. Which instruction should the nurse include?
- AHold the cane on the weaker side of the body.將拐杖握在身體較弱的一侧。
- BMove the cane and the stronger leg forward together.將拐杖與較強健的腿同時向前移動。
- CLean heavily on the cane to minimize weight-bearing on both legs.用力倚靠拐杖以最小化雙腿的負重。
- DHold the cane on the stronger side of the body.✓ 正解將拐杖握在身體較強健的一侧。
核心概念：助行杖的正確使用方法。正確使用助行杖的關鍵在於平衡與支撐。助行杖應握在「健側」（較強壯的一側），這樣當患側腿向前邁步時，健側的手臂可以同時移動助行杖，形成一個穩定的三角形支撐點。這種方式能有效減輕患側的承重壓力，並透過健側手臂的支撐來維持身體重心。臨床思路：護理師在衛教時應強調「杖健側」的原則，這與一般大眾直覺認為「哪邊沒力就握哪邊」相反。安全優先原則：確保病人在行走時視線平視前方，而非盯著腳看，以防止跌倒。其他選項如握在患側（A）、移動健側腿（B）或過度倚靠（C）都會增加重心不穩與跌倒的風險。
Core concept: correct use of a cane. The key to using a cane properly is balance and support. The cane should be held on the unaffected (stronger) side; in this way, when the affected leg steps forward, the arm on the unaffected side advances the cane simultaneously, forming a stable triangular base of support. This effectively reduces weight-bearing pressure on the affected side and uses the unaffected arm's support to maintain the body's center of gravity. Clinical reasoning: when providing patient education, the nurse must emphasize the "cane on the strong side" principle, which is counterintuitive to the common belief that the cane should be held on the weaker side. Safety-first principle: ensure the client looks straight ahead while walking, rather than down at the feet, to prevent falls. Other options, such as holding the cane on the affected side (A), moving the unaffected leg first (B), or leaning too heavily on the cane (C), all increase the risk of instability and falls.
在美國，物理治療師（PT）通常負責最初的步態訓練，護理師則負責日常活動的加強與衛教；台灣護理師則常需在病房內承擔更多的步態衛教與安全監測責任，且台灣病房空間通常較狹窄，需特別注意環境障礙物。