讓她洗得更舒適——照護一位腹膜透析患者之護理經驗

Making the Peritoneal Dialysis to More Comfortable-The Nursing Experience of a CAPD Patient

本個案報告主要在探討一位36歲糖尿病末期腎病變個案接受腹膜透析的護理經驗。筆者於88.7.15至88.11.15之護理期間，以Gordon十一項健康功能型態進行護理評估，發現個案有恐懼-洗腎、營養狀況改變、活動無耐力、自我照顧能力缺失、角色扮演改變、睡眠型態紊亂等健康問題。透過個案每次腹膜透析學習過程的護理、返診時的會談、住院時的探訪及電話的諮詢予個案相關之護理措施，結果其恐懼-洗腎、營養狀況改變'自我照顧能力缺失、活動無耐力及角色扮演改變等問題之處理皆可達到護理目標，唯其睡眠型態紊亂之問題未獲得滿意改善，此係因個案處於腹膜透析適應期之故，致適當護理措施仍有待討論。由本個案之護理經驗可知腹膜透析個案雖屬門診個案，但利用各種途徑執行持續性、個別化的護理對於追縱及解決其健康問題是非常重要的，如此才能使個案得以身心舒適地繼續接受腹膜透析。The main purpose of this study is to discuss the nursing experience in caring for a- diabetic CAPD patient. Using the Assessment Guide for Adult Patient ( Gordon M ) , this 36 year-old female patient was diagnosed with fears of dialysis, imbalanced nutrition, less than body requirements, self care deficit, activity intolerance, ineffective role performance, disturbed sleep pattern, etc. Through nurse directed CAPD teaching, and discussions conducted during follow-ups and admission, as well as phone consultations, we reached our nursing goals in this case with resolution of the above problems, except for the disturbed sleep pattern, although the CAPD case is one of out-patient cases, from the nursing experience of this case, we see that by using different ways to fulfill the continuity and the individuality required for nursing care, nurses can track and solve many of the health care problems that the CAPD patients face. All of these care methods could help the patient continue to accept CAPD by improving her comfort, both somatically and physically.