照顧一位接受腎移植手術失敗病患的護理經驗

Experience in Nursing: A Failed Renal Graft Transplantation Surgery

本文為探討一位35歲男性個案接受腎移植手術失敗的護理經驗，筆者於89.4.7-89.5.19期間，與個案及家屬建立良好的護病關係，以參與、觀察及面談等方式蒐集資料，並採Marjory Gordon(1982)所提出之十一項功能性健康型態為評估工具。發現個案有睡眠型態紊亂、潛在危險性感染、抉擇衝突、哀傷功能失調、無力感等護理問題，經由提供整體性、連續性的護理措施，協助個案克服腎移植手術失敗、移植腎摘除的抉擇、動靜脈瘻管再次手術不成功、無法完整擔任父親角色的失落及對醫療環境的無力感等多重考驗，而引導個案積極地走出腎移植失敗的陰影，協助其適應並坦然面對後續的治療。

A 35-year-old male patient suffered from renal graft failure following renal transplantation surgery. Since admittance, we had established a good relationship with this patient and his family and had observed them frequently. Using Gorden's functional health pattern, we found that the patient had a higher risk of becoming infected, sleep disturbance, confliction about decision-making, grieving dysfunction, and sense of powerlessness. During this time, we assisted the patient to overcome his frustration caused by the graft failure, to make the decision to remove the failed graft, and to re-establish an arteriovenous fistula. As a result of our nursing intervention, we believe that this patient has less of a sense of powerless about his living environment and less disability of role-play as being a father.