一位初次血液透析病人遭逢喪夫之痛的護理經驗

Nursing Experience of an Initial Hemodialysis Patient Who Suffered a Bereavement

李美娟(Mei-Chuan Li)

《臺灣腎臟護理學會雜誌》 14卷3期 (2015/09) Pp. 61-75

https://doi.org/10.3966/172674042015091403005

摘要

本文描述一位初次血液透析病人遭逢喪夫之痛的護理經驗，護理期間自2013年3月26日至 2013年5月11日，筆者藉由病歷查閱、身體評估、溝通、會談等方式蒐集資料，以生理、心理、社會及靈性四大層面，進行各層面評估分析並確立個案有體液容積過量、調適障礙、哀傷之相關健康問題。護理過程中共同擬定水份控制小叮嚀，採個別性護理來改善體液容積過量問題；透過觀察及互動過程發掘問題，於建立良好護病關係後，引導個案自我陳述與提供正確資訊，使個案能修正對血液透析之負向認知；利用透析環境重新建立其人際網絡、強化家屬間互動頻率，以降低對其亡夫的思念，能以正向態度面對未來的生活。

關鍵字

血液透析 ； 體液容積過量 ； 調適 ； 哀傷

並列摘要

This paper described the nursing experience of a patient undergoing hemodialysis for the first time when she suffered a bereavement. Between March 26, 2013 and May 11, 2013, the author collected data through physical assessment, communication, interaction and review of medical records…etc. After analysis of the four aspects of physiology, psychology, society and intelligence, the patient's health problems were determined to include excess fluid volume, impaired adjustment and grief. During the nursing process, we drew up ＂the tips for fluid restriction＂ to correct the excess fluid volume problem, and dealt with every problem detected through observation and interaction. We established a good rapport with the patient to guide her through self-narration and to provide correct information. The patient was therefore able to revise her negative perception of hemodialysis. The hemodialysis environment was used to rebuild the patient's social relationships, enhance interaction frequency with family member and reduce grief associated with the bereavement, and encourage the patient to adopt a positive attitude towards her future life.

並列關鍵字

hemodialysis ； fluid volume excess ； adjustment ； grief

參考文獻

Baraz, S., Parvardeh, S., Mohammadi, E., & Broumand, B. (2009). Dietary and fluid compliance: An educational intervention for patients having haemodialysis. Journal of Advanced Nursing, 66(1), 60-68. doi: 10.1111/j.1365-2648.2009.05142.x

Willams, B. R., Sawyer, P., Rosemam, J. M., & Allman, R. M. (2008). Marita status and health: Exploring pre-widowhood. Journal of Palliative Medicine, 11(6), 848-856. doi: 10.1089/jpm.2007.0190.

王尉芸、陳美容（2009）．體液容積過量之原理背景及護理．長庚護理，20（3），334-342。

台灣腎臟醫學會（2012 年 5 月 16 日）．台灣腎臟醫學會統計資訊．取自 http://www.tsn.org.tw/UI/H/H002.aspx

羅月雲、余美嬅、謝伶瑜（2010）‧血液透析病患在罹病過程中之訊息需求之探討‧領導護理，11（1），16-28。