照護一位糖尿病腎病變患者面對血液透析治療之護理經驗

Experience with Caring for a Patient with Diabetic Nephropathy Undergoing Hemodialysis

詹慧珠(Hui-Chu Chan) ； 宋琇鈺(Hsiu-Yu Sung) ； 邱淑慧(Shu-Hui Chiu) ； 劉志達(Jyh-Dar Liou)

《臺灣腎臟護理學會雜誌》 11卷4期 (2012/12) Pp. 62-72

摘要

本篇個案報告主要是引導一位糖尿病多重病變（眼、腎病變）患者如何面對血液透析過程中所遭遇的生理、心理與社會的問題。護理期間自2010年3月20日至2010年6月5日，筆者藉由身體評估、會談、查閱病歷、家庭訪視、透析紀錄等方式收集資料，並依生理、心理、社會家庭、靈性等層面進行分析，確立個案的主要健康問題有：營養不均衡：少於身體所需、情境性低自尊及家庭運作需要協助等。在照護過程中，筆者運用社工與民間團體的資源，提供個案經濟協助、家事服務並教導個案日常生活自理技能，以減輕個案的家庭負擔。引導個案建立正向的思考能力、肯定自己的貢獻，減輕個案的情境性低自尊並重新建立個案家庭運作的效能、改善個案的生活品質，以達到整體護理的目的。

關鍵字

糖尿病腎病變 ； 血液透析 ； 護理經驗

並列摘要

The subject of this report was a diabetic patient with multiple complications that received guidance on coping with the physiological, psychological and social problems encountered during hemodialysis. During the care period between March 20, 2010 and June 5, 2010, data was collected through interviews, physical examination, chart reviews, patient records, family visits and dialysis records. The data was analyzed to identify the subject's chief health problems: Imbalanced nutrition: less than body reguiremants, situational low self-esteem and need for family process. During the care process, the author leveraged the resources of social workers and private organizations to reduce the pressure on the subject's family by providing economic assistance, housekeeping services as well as teaching the patient the skills needed for self-sufficiency. By encouraging the subject to think positively and acknowledge the subject's own contributions, total care was achieved through reducing situational low self-esteem, putting the subject's family situation back in order and improving the subject's quality of life.

並列關鍵字

diabetic nephropathy ； hemodialysis ； care experience