血液透析患者與其婚姻關係之探討-以某診所為例

腎炎、腎症候群及腎性變病名列台灣地區十大死因之一，對國人來說，早期罹患尿毒症是無藥可醫，但隨著醫療的進步與發展，病患可以透過腎臟替代療法（腎臟移植、血液透析及腹膜透析法）來延續寶貴的生命，而此三種方法中，有高達九成以上的患者採用血液透析法治療。對於血液透析患者來說，除了生理機能衰退外，加上心理上的壓力，使患者身心俱疲。不但嚴重影響患者生活方式及品質，也造成男性病患不易勃起，女性病患停經或喪失生育能力，性功能障礙造成患者身心靈的衝擊，甚至嚴重影響患者的婚姻關係。除了血液透析患者外，其家屬也承受著極大的壓力，由其是婚姻關係中患者最親密的配偶，在照顧患者的過程中，所遭遇的難題及需求，非一般人所能瞭解，因此本研究透過血液透析患者及血液透析患者配偶婚姻關係需求與期望來瞭解雙方所感受的婚姻關係現況。在患者及家患部分分別以二量表加以探討：病患部分：（1）患者婚姻關係需求量表。（2）患者婚姻關係期望量表。配偶部分：（1）配偶婚姻關係需求量表。（2）配偶婚姻關係期望量表。透過上述量表加以分析整理所得之結論，提供政府、社會團體及血液透析醫療機構，對於血液透析患者及家屬在婚姻關係及需求上，能提供更優質的醫療照顧及服務。關鍵字：尿毒症、血液透析、婚姻關係、婚姻需求

關鍵字

尿毒症；血液透析；婚姻關係；婚姻需求

並列摘要

Nephritis, Neph-rotic Syndrome and Nephrosis are among the top 10 causes of death in Taiwan. For the Taiwanese people, uremia used to be an incurable disease in the past. However, as medical advancement and development took place, patients are now able to prolong their precious lives through renal replacement （kidney transplant, hemodialysis, and peritoneal dialysis. Among the three methods, over 90% of patients choose hemodialysis to treat their diseases. For hymodialysis patients, other than deteriorated physiological functions, the mental stress they experience make them weary both in body and mind. It not only seriously affect patients’ lifestyle and quality of life, male patients may experience difficulty in erection while female patients may experience stopped menstruation or lose the ability to reproduce. The sexual function impairment causes negative impacts on the body, mind and soul of the patients and even severely affects their marital relationship. In addition to hemodialysis patients, their family members are also subject to tremendous stress particularly the spouses. During the care taking process, the problems and needs related to the patients are hard for average people to understand. Therefore, in this study, through hemodialysis patients and their mates’ martial relationship and needs and expectations serve as reference in finding out the existing marital relationship emotionally experienced by both sides. With regard to the patients and their family members, two scales are adopted in the discussion: The patients: （1）The scale of the patients’ existing marital relationship and needs （2）The scale of the patients’ marital relationship and expectations The mates：（1）The scale of the mates’ existing marital relationship and needs （2）The scale of the mates’ marital relationship and expectations Based on the above scales, a conclusion is drawn after analysis and compilation. It shall serve as reference for the government, social groups, and hemodialysis medical institutions. It is able to provide better medical care and services in terms of marital relationship and needs for hemodialysis patients and their family members. Keyword： Uremia, Hemodialysis, Martial Relationship, Marital Needs