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一位末期腎病病人初期接受血液透析治療之護理經驗
Nursing Experience of Caring a patient with End Stage Renal Disease Patient Receiving Hemodialysis in the Early Days
摘要
本文為一位年輕女性初期接受血液透析所經歷身心衝擊之護理經驗。護理期間為2012年9月5日至11月12日，利用每次血液透析期間，藉由會談、觀察、身體評估及病歷查閱，運用Gordon十一項功能性健康型態評估，發現個案主要護理問題依序有高危險性感染、營養狀況改變、無望感、角色扮演改變。在護理過程與個案及家屬建立良好護病關係，依個案需求與個案、家屬及醫療國隊共同擬定整體照護計劃，提供血液透析導管照護資訊，使個案能正確執行導管換藥技術及辨別感染徵象，會診營養師共同教導個案營養之攝取及選擇。同時觀察個案在透析初期面臨疾病之衝擊造成無望感，並運用傾聽、支持系統及透過宗教信仰的寄託轉移注意力，以減輕不安情緒，讓個案重拾信心，肯定自己未來的期望與被需要的價值，能正向面對長期透析生活，回復原本角色功能，提升自我照顧能力及適應血液透析的新生活。
並列摘要
This case study described the nursing experience of caring a young woman who accepted hemodialysis treatment initially. The researcher collected the data by conversation, observation, physical assessment, and hemodialysis recording from September 5th 2013 to November 5th 2013. Gordon's 11-items functional health pattern was utilized to assess the patient's health problems. In analysis, it was identified that the patient had three nursing problems including high risk of infection change of, nutritional status, hopelessness, and change of role. In the nursing process, the treatment relationship of trust was built among the researcher, patient and her family. According to the patient's need, the caring planning established by medical team not only provided therapeutic information of hemodialysis, wound-care technique and infection symptoms, but also consulted the dietitian to educate for the diet choice. By applying attentively listening, supportive system and religious beliefs, the researcher resolved the patient's tension, and strengthened her confidence and hope. Finally the patient obtained a positive attitude toward hemodialysis and was able to face the changes in life.
延伸閱讀
- 邱淑芳、盧彩屏（2007）。照護一位末期腎病病人初次面臨血液透析之護理經驗。臺灣腎臟護理學會雜誌，6(1)，46-59。https://www.airitilibrary.com/Article/Detail?DocID=17267404-200706-6-1-46-59-a
- 韓雅奎、余文彬、李玉秀（2015）。照護一位末期腎病患者初次血液透析之護理經驗。領導護理，16(2)，33-43。https://doi.org/10.29494/LN.201506_16(2).0006
- 馬麗卿、謝湘俐（2008）。照護一位末期腎疾病患者面對血液透析治療之護理經驗。臺灣腎臟護理學會雜誌，7(1)，60-73。https://www.airitilibrary.com/Article/Detail?DocID=17267404-200806-7-1-60-73-a
- 郭昭玲、方莉（2013）。Nursing Experience for an End-Stage Renal Disease Patient Undergoing Hemodialysis for the First Time。臺灣腎臟護理學會雜誌，12(1)，72-86。https://www.airitilibrary.com/Article/Detail?DocID=17267404-201303-201305230034-201305230034-72-86
- 金美華、林雅蘋（2017）。A Nursing Experience of Caring an End-Stage-Renal Disease Patient who Receiving Hemodialysis for the First Time。領導護理，18(4)，22-33。https://doi.org/10.29494/LN.201712_18(4).0003