本研究係描述血液透析患者皮膚搔癢之相關問題,以做為皮膚癢之護理實證參考。自民國90年7月至12月於中部某醫學中心接受血液透析的患者共88位為研究樣本。以問卷與訪談方式收集資料。結果顯示血液透析病人皮膚癢之發生比率為61.4%,以透析後一年內發生皮膚癢者居多(81.5%),癢的部位依序為全身、軀幹及肢體(55.5%、27.8%、16.7%),癢的程度則以中、重度為最多(83.3%),且有一半以上(59.3%)的病患主訴影響睡眠。病患自行對皮膚癢的處理方式以手抓搔最為常見(74%),而病患自認為有效的處理方式,包括擦拭清涼溶劑(100%)、按摩按壓(100%)、轉移注意力(100%)、冷敷(100%)、手抓搔(90%)、使用藥物(90%)及擦拭乳液(54%)等。因而可瞭解本研究之病患使用上述處理方法有其個別性需求,故建議護理人員照顧血液透析患者之皮膚癢,應給予病患完整性的評估,尊重其個別需求,給予不同的照護。
This study describes the issues related to pruritus and self-management in hemodialysis (HD) patients. Using questionnaire and direct interview, we collected data from 88 patients at a medical center in central Taiwan between July and December 2001. Our results indicate that 61.4% of the HD patients developed pruritus, most (81.5%) occurring within one year after HD treatment. Among the patients surveyed, the pruritus occurred on the whole body (55.5%), on the torso (27.8%), and on the arms and legs (16.7%). Most of the pruritic problems (83.3%) ranged from medium to severe, and more than half (59.3%) of the patients reported having sleeping problems. Most of the patients responded to the pruritus by scratching with hands (74%). According to the patients’ responses, the most effective means of alleviating the pruritus included application of refreshing astringent (100%), massage with compression (100%), distraction (100%), cold application (100%), scratching (90%), using medication (90%) and application of lotion (54%), etc. Since each HD patient has his or her own preferred ways of effectively relieving pruritic problems, we should provide comprehensive assessment for each patient and individualized care.
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