運用舒適理論於一位腎臟移植病人之加護護理

Nursing Care by Comfort Theory for a Kidney Transplant Recipient

柯芷芸(Jhih-Yun Ke) ； 謝玉如(Yu-Ju Hsieh)

《臺灣腎臟護理學會雜誌》 17卷1期 (2018/03) Pp. 58-69

https://doi.org/10.3966/172674042018031701005

摘要

本文乃運用舒適理論協助腎臟移植病人面對術後感染及照護等生理負擔，加上腎功能延遲等心理壓力影響睡眠之加護護理經驗。筆者於2015年11月26日至12月1日護理期間經由直接護理、會談及觀察、查閱病歷等收集資料進行整體性評估，確立「組織灌流改變-腎」、「無效性保護能力」、「焦慮」、「睡眠型態紊亂」等問題。主動關懷建立護病關係，以舒適理論為基礎，落實評估並監測臨床徵象，與醫療團隊討論治療方式及衛教疾病相關知識，運用傾聽、同理心及親情關懷與鼓勵，讓病人達到心理慰藉，緩解身、心、靈的不適，使其感到自在，共同規劃健康計畫，增加信心與希望，以達到整體安適。盼分享此護理經驗，能提供日後照顧類似病人之參考，以提升護理照護品質。

關鍵字

腎移植 ； 延遲腎功能 ； 舒適護理

並列摘要

This article described a nursing experience using comfort theory to assist a renal transplant recipient to face the physiological burden and psychological stress such as postoperative infection, care and insomnia resulted from delayed renal function recovery. From November 26, 2015 to December 1, 2015, the author directly cared, interviewed, observed, and inspected the medical records to make a holistic assessment that the patient had the following problems: tissue perfusion changes - kidney, ineffective protecting ability, anxiety, sleep disorders. Author used some methods to relieve patient from discomforts of his body, soul and spirit. Also arranged health plans with him to increase his confidence and hope, so as to achieve overall comfort. Those methods we adopted, included active care to establish the relationship between nursing providers and patients; implementation of assessing and monitoring of clinical signs by using comfort theory; discussed treatment with medical team; offered health education about disease-related knowledge; and used listening, empathy and family participation to encourage the patient. Experience shared in this article will hopefully provide peers with a useful reference in caring for such patients in the future.

並列關鍵字

renal transplantation ； delayed renal function ； comfort nursing

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