照顧一位限水病患的護理經驗

Nursing Experience of a Restricted Water Intake Patient

本報告描述照護一位心衰竭患者，在住院期間因限水導致口渴不適，進而引發身、心、靈問題的護理經驗。筆者於91年6月17日至7月13日護理期間，利用田野研究法，完成與患者及其家屬會談及互動的行為過程紀錄共15篇。經內容分析法，整理出患者因口渴不適所引發的生理與心靈層面的問題。生理層面的問題包括：口乾不適及無法獲得適當休息；心靈層面的問題包括：生命無意義、喪失自尊及自主權。藉由提供患者愛玉、牛奶冰及人工唾液，在有效減少水分攝入之同時，亦緩解患者口渴的需求；並運用生命回顧、宗教力量及家屬支持，因應口渴所導致心靈上的衝擊。加上於護理過程中不斷與醫療團隊討論合理之限水範圍，最後終能使患者口渴問題獲得改善，重拾心靈的平靜。

This case study reported a heart failure patient who had physical, mental, and spiritual problems induced by restricted water intake during hospitalization. Fifteen sheets of process recording were written. The process recording employed field study method to collect data during interacting with the patient and her families. Content analysis was used to analyze problems arose from thirsty. Physically, it included thirst discomfort and restlessness. Mentally and spiritually, the thirsty problem was aggravated by loss of life meaning, low self-esteem, and loss of self-autonomy. Improvements to the patient's thirst condition was suggested jelly-fig, milk ice, and artificial saliva. Moreover, strived for reasonable range of restricted water for the patient and use of life review, religious comfort, and family support may also be effective. The result was to alleviate the feeling of thirst, and to reshape life meaning mentally and spiritually.