護理師正在教導病人如何使用助行杖(單拐)。下列哪項指導是正確的?
A nurse is teaching a client how to use a cane. Which instruction is correct?
- AThe cane height should reach the level of the waist拐杖高度應達腰部水平
- BAdvance the strong leg forward first with the cane先將拐杖與強健側腿向前移動
- CHold the cane on the weak side of the body將拐杖握於身體弱側
- DHold the cane on the strong side of the body✓ 正解將拐杖握於身體強健側
使用單拐(Cane)的基本邏輯是擴大支撐基底並分擔患側的重量。正確的做法是將拐杖握在『健側(強側)』。當病人邁開患側腿時,健側的手同時向前移動拐杖,這樣重心就會落在拐杖與健側腿形成的穩定區域內,有效保護弱側。拐杖的高度應設定在『大轉子(Greater trochanter)』或手腕摺痕處,使手肘保持約 15-30 度的微彎,而非到腰部(A)。前進順序應為:拐杖先出,接著患側腿,最後才是健側腿。護理師在衛教時應強調『拐杖與患側腿同步』,這能最自然地模仿人體行走時手腳交叉擺動的力學。
The basic principle of using a cane is to widen the base of support and offload weight from the affected side. The correct technique is to hold the cane on the 'strong (unaffected) side.' As the client steps forward with the affected leg, the hand on the strong side advances the cane at the same time, so the body's center of gravity remains within the stable area formed by the cane and the unaffected leg, effectively protecting the weaker side. The cane height should be set at the level of the greater trochanter or the wrist crease, with the elbow flexed about 15-30 degrees — not at waist height (option A). The forward sequence is: cane first, then the affected leg, and finally the unaffected leg. In teaching, the nurse should emphasize that 'the cane and the affected leg move together,' which most closely mimics the natural reciprocal motion of arms and legs during walking.
美國 NCLEX 考試極度重視「Cane on the Strong Side (COAL)」這個口訣;台灣臨床有些家屬會誤以為拐杖要放在痛的那一邊,護理師需花較多時間糾正錯誤認知。