一位接受腎臟移植病患術後之護理經驗

The Nursing Experience of Postoperative Care of a Kidney Transplant Patient

成功的腎臟移植帶來最直接的效益，就是讓尿毒症患者擺脫透析治療中伴隨的痛苦和限制，進而大幅地提昇生活品質。本文是描述一位末期腎衰竭的男性患者，經歷六年的血液透析，最終接受腎臟移植手術術後之護理經驗。筆者經由觀察、會談等方式收集資料。照護期間為2009年3月15日至2009年4月8日，運用Gordon十一項功能性健康模式做整體性評估，加以歸納分析，確立個案有高危險性感染、焦慮、睡眠型態紊亂三個主要護理問題。護理過程中，筆者扮演支持、照護及教導者的角色，與個案建立良好護病關係。除此之外，還運用腎臟移植衛教手冊及記錄本，讓個案參與照護計劃。在護理方面，筆者向病患及家屬解釋嚴密的保護隔離措施之必要性，使個案住院期間無感染徵象；安排成功案例經驗分享、及家人一起給予心理的支持及陪伴，以減輕病患心中的焦慮。除此之外，筆者還提供音樂療法、深呼吸及肌肉放鬆法，幫助個案抒發心理感受及改善睡眠問題。筆者的目標是針對個案護理問題，提供適當護理措施，使個案能順利出院並正向面對未來。The cardinal benefit of successful kidney transplantation is to release suffering and restriction which are associated with dialysis treatment in an uremic patient, and thus the improvement of life quality can be achieved. This article describes the nursing care on an end-stage renal disease patient who had received hemodialysis for six years and received kidney transplantation finally. The author collected data by observing and interviewing the patient. During the care-giving period from 3/15/2009 to 4/8/2009, the data was collected through the use of Gordon's Eleven Functional Health Patterns, followed by summarization and analysis. The patient has three major nursing problems, including high risk for infection, anxiety, and sleeping disturbance. During the nursing care period, the author played a role in supporting, educating, and giving care to establish a good relationship with this patient. In addition, the patient was involved into the caring process by using kidney transplant health education manual and record sheets. By nursing care, the author proved some strategies for the care of kidney transplantation. These strategies include isolation to avoid infection, introduction of other patients who had successful experience to share their experience, family emotional support to decrease the patient's anxiety, music therapy, deep breathing therapy, and muscle relaxation therapy in order to help the patient express his feelings and improve his sleeping problem. The goal of this article is to provide appropriate nursing care regarding patient's individual problems so that he can face the future with a positive attitude.