糖尿病腎病變中年洗腎病患之生活經驗

The Lived Experience of Middle-aged Hemodialysis Patients With Diabetic Nephropathy

林庭如(Ting-Ju Lin)

指導教授 ： 黃惠滿

長榮大學/健康科學學院/護理學系(所)/碩士(2015年)

https://doi.org/10.6833/CJCU.2015.00116

摘要

臺灣末期腎病之盛行率位居世界之冠，而糖尿病腎病變為致使病患接受洗腎治療的首因。本研究目的為了解糖尿病腎病變中年洗腎病患的生活經驗，採用現象學方法，以立意取樣方式，於2014年11月至2015年05月，在南部某區域教學醫院，運用深度訪談方式，收集12位糖尿病腎病變中年洗腎病患資料。以Colaizzi的現象學分析法進行資料分析，結果歸納出四個主題及十個次主題：（一）飽受身心煎熬：拒洗腎欲求死、悲觀看待人生、糖尿病及洗腎併發症齊纏身；（二）生活受限制：生活及休閒阻礙多、經濟陷窘境倍感壓力；（三）尋求調適方法：打開心門納助力、心念轉向漸接受、學習促進自我健康；（四）從接近死亡中領悟珍惜：風中殘燭靜待死亡、珍愛家人共度餘生。此結果深入了解糖尿病腎病變中年洗腎病患身心煎熬、生活受限、領悟珍惜的經驗及其所採用的調適方法，期望能提供護理人員臨床照護時之參考。

關鍵字

洗腎病患 ； 糖尿病腎病變 ； 生活經驗 ； 中年

並列摘要

The prevalence of end stage renal disease （ESRD） in Taiwan is the highest in the world; diabetic nephropathy is the primary reason that patients receive hemodialysis. The purpose of this study was to observe the actual physical experiences of middle-aged patients dealing with diabetic nephropathy and receiving hemodialysis. A qualitative phenomenological approach was employed at a teaching hospital in southern Taiwan from November 2014 to May 2015. Targeted sampling was used to recruit participants. The data from 12 middle-aged diabetic nephropathy patients receiving hemodialysis was collected using in-depth interviews. Colaizzi’s phenomenological analysis method was used for data analysis, and the analysis results were categorized into 4 themes and 10 subthemes. The themes of real life experiences included：(a) Mental and physical suffering: refusing hemodialysis and desiring to end their lives; regarding life pessimistically; being disturbed by their diabetic and hemodialysis conditions. (b) Life limitations: obstruction of normal life and leisure activities; the pressure induced from financial hardship. (c) Adaptation: being open-minded and permitting others to assist them; changing their mind to accept hemodialysis; learning to improve their self-health; and (d) End-of-life evaluation: feeling their lives were like a candle flickering in the wind as they awaited death; appreciating their lives and families. The results of this study can clarify the mental and physical suffering, life limitations, adaptation, and end-of-life evaluation among diabetic nephropathy patients receiving hemodialysis. These results can provide useful information to improve nursing care and thereby to improve patient’s lives.

並列關鍵字

Hemodialysis patient ； diabetic nephropathy ； lived experience ； middle-aged

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