一位因長期接受血液透析感染C型肝炎患者之護理經驗

The Nursing Experience of a Long-term Hemodialysis Patient with Infection of Hepatitis C

劉旆辰(Pei-Chen Liu) ； 張秋純(Chiu-Chun Chang) ； 賴美玉(Mei-Yu Lai)

《中山醫學雜誌》 23卷1期 (2012/03) Pp. 33-43

https://doi.org/10.30096/CSMJ.201203.0005

摘要

本文在探討一位接受長期血液透析患者，在治療過程因輸血導致C型肝炎國染之護理經驗。筆者在護理期間運用Gordon 十一項健康功能型態評估為指引，確立個案主要的護理問題有（1）營養狀況改變、（2）焦慮、（3）個人因應能力失調等健康問題。在護理過程中筆者與個案及家屬建立良好護病關係，筆者籍由傾聽了解造成個案護理問題的真正原因，並適時提供澄清，增進個案對血液透析與C型肝炎相關資訊的了解，並針對個案身心健康需要提供個別性之護理計畫與措施，並運用血液透析室護理人員之專業知識及技能，協助個案處理健康問題，讓個案善用醫護團隊與社會支持團體資源，提升個人對於透析與肝炎照護相關知識，以避免肝炎的傳染與合併症的發生。筆者希望藉此推理經驗，提供血液透析室護理人員照顧類似個案時，能深入了解患者需求，滅少個案抗拒或是不合作行為，增強個人的自信心去面對健康問題，使個案重新掌控透析狀況。

關鍵字

血液透析 ； C型肝炎

並列摘要

This article presents the nursing experience caring for a Long-Term hemodialysis patient with Hepatitis C. From June 1 to July 30 in 2008, Gordon's functional health assessment guide was used to analyze data collected through conversation, observation, direct care, and physical histroy, hemodialysis recordings and laboratory examination of this case. Finally, we identified 3 problems: (l) nutritional status change, (2) anxiety, and (3) inability to self-care. After a therapeutic nurse-patient relationship was established, we used care, empathy, support, acceptance, and nursing skillsto design a nutrition menu for the patient and provide him with information on Hepatitis C and necessary self-care procedures. Using both family member participation and peer group counseling to share experience, we were able to improve the patient's mood, strengthen his self-confidence to face health questions and control dialysis condition again in the future.

並列關鍵字

Hemodialysis ； Hepatitis C