- 期刊
運用羅氏適應理論照護一位初次接受血液透析病人之護理經驗
Nursing Experience of a Patient Undergoing First-time Hemodialysis Examined Through the Roy Adaptation Model
摘要
本文探討一位末期腎衰竭須接受血液透析治療病人之護理經驗。護理期間自2018年5月1日至7月31日，筆者運用羅氏適應理論進行評估，經由觀察、會談、身體評估及病歷查閱等方式收集資料，發現病人主要健康問題為：體液容積過量、無效性自我健康管理、焦慮。照護過程中病人因對透析治療模式不清楚而出現排斥血液透析治療情形。因此，筆者照護過程中，運用同理心、主動關懷與病人建立信任、良好的護病關係，傾聽及接納病人內心的想法，陪伴病人心理調適並以正向的態度去面對透析治療過程。接著依病人訂定個別性照護計劃，同時教導病人及家屬瞭解水分控制相關照護知識，避免再次出現體液容積過量之併發症。同時，藉由腎友經驗分享及實際操作血管模組等方法，增加病人對血液透析通路的認知，提升自我照顧能力。持續觀察病人學習情形，適時調整照護模式，提供正確的資訊，使病人能以正向的態度面對血液透析治療衝擊，建立良好適應態度，最終能回歸正常的社會生活。
並列摘要
This paper discusses the nursing experience of a patient receiving active care in the form of hemodialysis for end-stage renal failure from May 1, 2018, to July 31, 2018. Using the Roy adaptation model, the author assessed the case and collected data through observation, communication, physical assessment and reference to medical records, which revealed that the main health problems were excessive fluid volume, ineffective self-health management and anxiety. Specifically, the patient's lack of adherence to treatment appeared to be attributable to anxiety concerning the hemodialysis intervention. To help the patient accept the situation and undergo treatment with optimism, the author was empathetic toward the patient in the process of care and established a rapport with the patient. Moreover, the author tailored the care plan to the patient's specific needs, teaching the patient and the family members about the importance of fluid balance and the prevention of recurring complications from fluid overload. The author also helped reinforce the patient's understanding of the treatment, including the operation of vascular modules. In addition, to improve self-care abilities, the author arranged for other patients with renal disease to share their positive experiences. Continuous observation of the patient's situation, timely adjustment of the care model and the provision of accurate information helped the patient face hemodialysis treatment with a positive attitude, adapt to her situation, and eventually return to normal life.
參考文獻
延伸閱讀
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