一位血液透析個案——因多重壓力致身心衝擊之照護經驗

Nursing Experience of a Long-Term Hemodialysis with Multiple Stress

探討一位長期接受血液透析個案，近來案夫罹瘤，自責受自己拖累又承受飲食限制之苦，對生命產生消極想法；案夫罹瘤怕無法勝任照護，經護理介入，重尋生命意義的護理經驗。護理期間為2010年10月12日至2010年12月30日，運用Gordon 11項健康功能型態評估，藉由會談、觀察、身體評估及查閱病歷等收集資料，確立健康問題為1. 無望感2. 電解質不平衡3. 照顧者角色緊張。筆者加強個案內心表達，採關懷，正向思考，有效降低無望感，增強自我照顧知識、按巧，減少高鉀食物攝取，不再發生血鉀過高，充分告知照護技巧，降低主要照顧者緊張壓力，最後協助個案及家屬獲得身、心、靈平靜，面對未來長期透析生活，確實提升生活品質。

The study explores a long-term hemodialysis patient who was suffering from multiple stress due to dietary restrictions as well as her husband's newly diagnosed with cancer. The nursing period was from December 10, 2010 to December 30, 2010. By applying Gordon's eleven health function's evaluation through interview, observation, physical assessment and chart review, the nursing problems of the patient as follows: 1. hopelessness, 2. electrolyte imbalance, 3. caregiver role strain. The nursing interventions were encourage the patient to adjust stress and get rid of negativity resulting in reducing the hopelessness and empowering the patient with self-care skills to restrain diet intake resulting in no longer occurring hyperkalemia. In addition, decreasing caregiver role strain resulting in assisting the patient and her family get the body, mind, and spirit calm. While hemodialysis is a long-term process for the patient, individualized and continuous nursing care can be provided to help the patient come to terms with dialysis and improve her quality of life.