運用哀傷輔導策略協助血液透析個案面臨喪偶衝擊之護理經驗

本文旨在探討一位69歲血液透析個案面臨喪偶衝擊之護理經驗。護理期間自2020年2月24日至5月30日，筆者運用Gordon十一項健康功能型態為評估架構，藉由會談、傾聽、身體評估及實際照護方式收集資料，確立個案主要的健康問題為哀傷、睡眠型態紊亂及無效性健康維護能力，護理過程運用Worden哀傷輔導模式提供個別性照護，並與家屬一起協助個案表達內心感受及找尋生活的新動力；運用非藥物輔助療法，如：芳香療法、溫水足浴及調整生活型態，改善睡眠品質；另藉由評估個案對於高血磷的認知與態度，與家屬共同討論個別指導方式，加以提醒及修正個案自我照護行為，促使血磷控制於2.5-5.5 mg/dl正常範圍內。冀望藉此護理經驗能提供日後臨床血液透析護理同仁照護參考。

關鍵字

血液透析；喪偶；哀傷輔導

並列摘要

This article is about the nursing experience of a 69-year-old hemodialysis patient who was facing widowhood. The nursing period is from February 24th to May 30th, 2020. Assessment by Gordon's 11 health functional patterns, the author collects information through talks, listening, physical evaluation and clinical care and make sure the main health problems of this patient as grief, sleep pattern disorders and ineffective health maintenance. I try to apply the Worden grief counselling model and works with family members to help this patient expressing her feelings and finding a new motivation for life. During this process, I apply adjuvant therapies, such as aromatherapy, foot bath with warm water and lifestyle adjustment to improve sleep quality. In addition of this, depending on her cognition and attitude of hyperphosphatemia I set up an individual care plan with family members and try to remind and correct her self-care behavior, and promot blood phosphorus control within the normal range of 2.5-5.5 mg/dl. I look forward to this nursing experience can provide reference for future clinical hemodialysis nursing care.

並列關鍵字

hemodialysis ； widowhood ； grief counseling

參考文獻

吳麗珍、周傳姜、林妍君（2017）．哀傷理論於喪親家屬之護理應用．護理雜誌，64（6），98-105。https://doi:10.6224/JN.000088

李月萍、陳清惠（2016）．喪偶對高齡者健康及生活之衝擊及護理．護理雜誌，63（4），19-24。https://doi:10.6224/JN.63.4.19

林姿佳、廖彥琦（2016）．陽光照射對老人健康之影響．護理雜誌，63（4），116-122。https://doi:10.6224/JN.63.4.116

楊芝齡、鄭綺（2019）．護理之家與社區老人睡眠品質及預測因子之比較．新臺北護理期刊，21（1），31-44。https://doi:10.6540/NTJN.201903_21(1).0004

Covic, A., & Rastogi, A. (2013). Hyperphosphatemia in patients with ESRD: assessing the current evidence linking outcomes with treatment adherence. BMC nephrology, 14, 153. https://doi.org/10.1186/1471-2369-14-153

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