護理師正在教導一名左側肢體無力的病人如何使用手杖行走。護理師應包含下列哪項指導？

此題的核心概念是手杖使用的基本原則：COAL（Cane Opposite Affected Leg）。對於左側肢體無力的病人，手杖應握在強健側（右側），以增加支撐基底並減輕患側的承重壓力。行走時，手杖應先向前移動，接著患側腳（左腳）向前跨出，使身體重量均勻分佈在手杖與健側腳之間，最後健側腳再跨過手杖。這種順序能最大程度模擬正常步態並預防跌倒。選項 D 和 B 錯在手杖拿法，握在患側會導致重心不穩；選項 C 錯在移動順序。護理師在衛教時，應強調手杖的高度應調整至大轉子處，使肘關節維持約 15-30 度的屈曲，並提醒病人視線應平視前方，而非盯著腳尖，以維持平衡。安全性是 Basic Care & Comfort 領域的首要考量，正確的輔具使用能顯著提升病人的活動力與自信心。

The core concept of this item is the basic principle of cane use: COAL (Cane Opposite Affected Leg). For a patient with left-sided weakness, the cane should be held in the stronger hand (right side) to broaden the base of support and reduce weight-bearing pressure on the affected side. When walking, the cane should be moved forward first, followed by the affected leg (left leg) stepping forward so that body weight is distributed evenly between the cane and the unaffected leg, and finally the unaffected leg steps past the cane. This sequence most closely mimics a normal gait and prevents falls. Options D and B are incorrect because they hold the cane on the affected side, causing instability; option C is incorrect in the sequence of movement. When teaching, the nurse should emphasize that the cane height should be adjusted to the greater trochanter so that the elbow is flexed about 15–30 degrees, and remind the patient to keep the eyes looking forward rather than at the feet to maintain balance. Safety is the primary consideration in the Basic Care and Comfort domain, and proper use of assistive devices substantially improves a patient's mobility and confidence.

在美國，物理治療師（PT）通常負責初始評估與輔具選用，護理師則負責日常活動的加強教育與安全監測。在台灣，由於病房人力與職能分工差異，護理師常需承擔更多輔具使用的衛教工作，且對於行走步態的細節要求在臨床評鑑中佔有重要地位。