- 期刊
協助一位腎病患者面臨腎移植抉擇之護理經驗
Assist a patient with kidney disease to face the first choice of nursing experience for kidney transplantation
摘要
本文探討一位罹患糖尿病、高血壓導致末期腎病，初進入血液透析治療患者，因親人血液透析負面經驗感到痛苦，欲選擇腎移植延續生命，處於移植評估的階段，開刀植入右下鎖骨永久性導管，先行血液透析等待活體腎移植的護理經驗，照護期間為2019年10月07日至10月30日，運用Gordon十一項功能性健康型態評估，確認個案有潛在危險性感染、知識缺失及抉擇衝突之健康問題。照護過程除了提供導管留置及傷口照護之護理指導，從日常生活來預防透析導管潛在性的感染，且因對腎臟移植的資訊缺乏而有不確定感，及擔憂大女兒捐贈健康受損產生困擾，利用腎臟替代療法文宣、圖片解說其差異性，結合腎臟移植小組及醫療團隊，以提高決策力並接受其選擇的透析模式，協助個案選擇最合適的治療模式，提升自我照護能力及恢復家庭角色扮演，期望能將此護理經驗可作為照護類似病人之參考。
並列摘要
This article discusses the nursing experience of a patient with end-stage renal disease caused by diabetes and hypertension who was newly entering hemodialysis treatment. Feeling pain due to the negative experience of hemodialysis of his relatives, he wants to choose kidney transplantation to prolong his life. In the stage of transplantation evaluation, he underwent surgery to implant a permanent catheter in the right subclavian area, and hemodialysis was performed first, waiting for living donor kidney transplantation. The nursing period was from October 7th to October 30th, 2019. The Gordon 11 functional health assessment was used to confirm that the patient had health problems of potentially dangerous infection, lack of knowledge and conflict of choice. The nursing process not only provides nursing guidance on catheter indwelling and wound care, but also prevents potential infection of dialysis catheters from daily life. The patient is uncertain due to the lack of information about kidney transplantation, and worries about the health damage of the eldest daughter's donation. Combined with the kidney transplant team and medical team, we use renal replacement therapy literature and pictures to explain its differences, so as to improve decision-making and accept the dialysis mode of choice, assist patients to choose the most appropriate treatment mode, improve self-care ability and restore family roles. We hope that this nursing experience can be used as a reference for caring for similar patients.
延伸閱讀
- 吳（女秀）嫚、鄭采宸、吳律嫻（2020）。照顧一位末期腎病患者接受腎臟移植手術之護理經驗。彰化護理，27(3)，111-123。https://doi.org/10.6647/CN.202009_27(3).0014
- 蘇桂燕（2012）。協助一位腎病患者選擇透析模式之護理經驗。臺灣腎臟護理學會雜誌，11(3)，75-87。https://www.airitilibrary.com/Article/Detail?DocID=17267404-201209-201211270037-201211270037-75-87
- 蕭惠玲、張淑娟、吳明珠（2013）。一位透析個案面臨腎移植抉擇之護理經驗。澄清醫護管理雜誌，9(2)，64-73。https://www.airitilibrary.com/Article/Detail?DocID=18136702-201304-201305210022-201305210022-64-73
- 魏翠媛、陳珊吟（2003）。照顧一位接受腎移植手術失敗病患的護理經驗。臺灣腎臟護理學會雜誌，2(2)，171-185。https://www.airitilibrary.com/Article/Detail?DocID=17267404-200312-2-2-171-185-a
- 周桂君、李明哲、蔡娟秀（2016）。Kidney Transplantation in Patient with Diabetes。腎臟與透析，28(2)，72-75。https://doi.org/10.6340/KD.2016.28(2).05