照顧一位不遵從血液透析醫囑病人之護理經驗

Nursing Care for a Hemodialysis Patient with Poor Compliance

宋文英(Wen-Ying Sung) ； 鄒淑萍(Shu-Ping Chou) ； 蔡明足(Ming-Tsu Tsai)

《北市醫學雜誌》 7卷2期 (2010/06) Pp. 177-183

https://doi.org/10.6200/TCMJ.2010.7.2.10

摘要

目的：本文旨在描述一位69歲血液透析不遵從病人之護理經驗。方法：以Gordon十一項健康功能型態為評估架構，藉由觀察、會談及病歷查閱方式收集資料。結果：發現個案有體液容積過量、不遵從、無望感等問題。經由加強個案瞭解體液容積過量對身體健康的危害性，準備好鈣、磷結合劑於攜帶型小藥盒中，針對無望感，護理重點放在陪伴、傾聽與同理之技巧，提供持續性關懷及連續性護理。結論：經上述護理措施介入後，結果達到改善水分過多、未規則服藥及血磷過高之問題；並提升個案調適能力，而能達到最佳的透析生活品質。

關鍵字

血液透析 ； 體液容積過量 ； 不遵從 ； 無望感

並列摘要

Nursing experience with a 69-year-old noncompliant hemodialysis patient is described. Based on the Gordon's model, the author collected information and data by interview and char t review. Noncompliance, excess body fluids, and hopelessness were defined as the major problems to be dealt with. As a result, the patient was educated to understand that excess body fluids could be dangerous to her health. In order to improve medicine compliance, the patient was provided with a small medicine box and persuaded to take this box with her in order to remind her to take her medicines on time. Finally, in order to reduce her feeling of hopelessness, the author focused on listening skills and providing the patient with company to alleviate any concerns and to help with her nursing care. As a result, the excess body fluid problem has been improved, the noncompliance with medication has been corrected, and hyperphosphoremia has been diminished. At present, the patient has achieved a better quality of life during her hemodialysis period.

並列關鍵字

hemodialysis ； fluid overload ； noncompliance ； hopelessness