提升一位老年患者初接受血液透析自我照顧能力之護理經驗

本文描述一位老年糖尿病腎病變併慢性腎臟病第四期個案，選擇未來接受血液透析治療並預先建立動靜脈瘻管，在缺乏心理準備下即進入透析治療階段，治療初期因對自我照顧方式不了解，而引發焦慮情緒之護理經驗。護理期間自2020年2月18日至3月31日，筆者運用五大層面進行整體性評估與收集資料，確立個案有體液容積過量、健康維護能力失常、焦慮之健康問題；護理期間提供個別性照護措施，使個案進而適應老年透析生活。建議未來可將透析護理指導製作成衛教影片，並編製QR code條碼使透析患者及家屬能透過智慧型手機的普遍性與便利性即時獲取衛教資訊，對於強化其自我照顧能力及提升老年透析生活品質達雙重之效。

關鍵字

血液透析；老年人；自我照顧能力

並列摘要

This article describes the nursing experience of caring an elderly diabetic nephropathy and stage 4 chronic kidney disease patient received arteriovenous fistula creation after decided hemodialysis treatment, leading him to long-term hemodialysis without preparation and felt anxious due to lack of self-care ability. During nursing period from February 18 to March 31, 2020, following the five major aspects, the problems included excessive fluid volume, ineffective health maintenance, and anxiety. During the nursing process, the author provided individual care to help patient adapted to the elderly dialysis life. Make dialysis health education video, generate QR code can help dialysis patients and families obtain health education information immediately through the universality and convenience of smartphones, which can have a dual effect on strengthening self-care ability and improving the quality of elderly dialysis life.

並列關鍵字

hemodialysis ； elderly ； self-care

參考文獻

王正惠、林佳玲、王美娥、吳桂芳、周獻章、江明哲、蔡幸（2014）‧提升血液透析病患水分控制之專案‧臺灣腎臟護理學會雜誌，13（3），12-25。https://doi.org/10.3966/172674042014091303002

何雅芳、楊慕慈、陳金順、胡方翔（2015）‧長期血液透析病患血磷控制遵從行為相關因素之研究，臺灣腎臟護理學會雜誌，14（1），1-18。https://doi.org/10.3966/172674042015031401001

吳紅蓮（2016）‧血液透析病人控制血鉀的重要性－飲食策略‧腎臟與透析，28（4），155-159。https://doi.org/10.6340/KD.2016.28(4).01

呂淑卿、李碧霞、謝湘俐、莊宇慧（2017）‧血液透析患者動靜脈瘻管阻塞原因及預防與居家照護‧臺灣腎臟護理學會雜誌，16（3）1-12。https://doi.org/10.3966/172674042017091603001

李秀珠、方梅珍、蔡曉薇、徐南麗（2016）‧血液透析患者護理指導認知程度之探討‧健康與建築雜誌，3（3），43-51。https://doi.org/10.6299/JHA.2016.3.3.R4.43

主題瀏覽