運用賦權協助一位初次面臨腹膜透析患者自我照顧提升之護理經驗

Nursing Experience While Assisting a Patient Faced with Their First Peritoneal Dialysis Involving the Use of Empowerment to Promote Self-care

本文是運用賦權概念協助一位初次接受腹膜透析個案自我照顧之經驗。護理評估期間自2007年7月27日至2007年9月28日止，運用Orem自我照顧理論評估個案，自我照顧能力缺失的問題有：體液容積過多、健康維護能力改變及焦慮；筆者針對此護理問題，運用賦權訓練提供各項護理措施，運用傾聽溝通技巧與個案建立信任感了解個案困難及需求，與個案共同討論維護健康之活動，改變個案不健康行為及觀念，個案對慢性腎衰竭有所認知，並且接受透析之事實，執行腹膜透析技術不再感到焦慮害怕，且更加有自信及獨立感，重新開始新生活。

This study describes the use of empowerment to help a patient to accept their first self-care peritoneal dialysis. From July 27(superscript th), 2007 to September 28(superscript th), 2007, while attending the patient, the Orem theory was used with this patient to promote self-care. The questions that needed to be assessed included controlling the volume of body fluid in order to safeguard the patient's health, the patient's increased anxiety about the process and the patient's worries about carrying out the process in a safe manner. In order to address these problems, empowerment was used to train the patient in how to measure accurately, use the machine correctly and listen attentively to any instructions. This built up a sense of trust with the patient and help to identify any problem areas. Safety procedures were discussed with the patient including changes in behavior that would improve their health. The patient was able to recognize that they were suffering from chronic kidney failure to some extent and began to accept the fact that dialysis was necessary. This reduced their feelings of anxiety as well as their fear of the dialysis technology. As a result, the patient began to carry out the peritoneal dialysis successfully and this was associated with feeling more confident and independent. This, in turn, allowed the patient to resume their life in a new context.