照護一位老年失智患者接受血液透析之護理經驗

The Nursing Experience of Caring for a Dementia Patient with Hemodialysis

本文描述一位老年失智患者接受血液透析之照護經驗，護理期間自2011／7／4至10／20，筆者於照護中應用羅氏適應模式進行評估，透過直接照顧、觀察、會談、電話連絡等方式收集資料，確立個案護理問題為知識缺失以及慢性混亂等問題，護理過程藉由每次血液透析，給予評估衛教，需要時電話與失智病房護理人員討論，提供製作及張貼人工血管禁止執行事項圖片、播放衛教CD，運用團隊合作等個別性護理措施協助個案，使其在醫護團隊支持下，減少血液透析時出現的混亂，增加血管照護的知識及記憶。經本文提供措施後，患者對時間、環境的定向感增加，把血管照護變成日常生活的一部分，可情緒平穩的接受規則血液透析。

This article describes a nursing experience of caring for an elderly dementia patient with hemodialysis. From July 4 to October 20, 2011, the author applied Roy's Adaptation Model for patient assessment, and collected data through direct care, observation, interview and telephone contact. The main nursing problems were the patient's lack of knowledge and altered mental status. The provided nursing care included patient education assessment during patient hemodialysis, telephone contact with the nurse in the dementia unit (as needed), instruction posters for caring for artificial blood vessels and patient education CDs. The patient became less confused during hemodialysis and more aware of vascular care. With all of the offered interventions, the patient became more oriented to the time and environment, able to accept vascular care as part of daily life, and received hemodialysis regularly while emotionally stable.