運用Neuman理論協助一位初次血液透析治療病患調適之護理經驗

Nursing Care for the Uremic Patient Undergoing Their First Hemodialysis Treatment Guided by the Neuman Systems Model

本文乃運用Neuman系統模式，探討一位初次接受血液透析病患之壓力，以期能協助病患解決問題並接受透析治療。護理期間為：90年12月23日至91年5月31日，經實際護理、會談及觀察方式收集資料，並將會談內容、觀察之行為加以分析，評估後發現個案呈現問題有1.身體不適感2.調適障礙3.健康尋求行為4.社交隔離，藉由Neuman模式提供初級、次級、三級護理措施，使個案能認識血液透析進而能調適壓力，改善因疾病所造成之身體不適與適應血液透析所造成的改變，建立正確自我照顧方式，並使其能以健康的態度，走入人群，積極參加社交活動，並勇敢面對長期血液透析治療。

We herein discuss the stress of a uremic patient who first received hemodialysis treatment based on the Neuman system model and our attempt to help the patient resolve her problems and accept her condition. The duration of nursing care for this patient was from December 23, 2001 to May 31, 2002. The data collection method employed used practical nursing care, interviews with a questionnaire and close observation. After the data was analyzed we found that the present problems of the patient were as follows: 1. a sensation of physical discomfort, 2. adaptation disorder, 3. health-seeking behavior, 4. isolation from society. Guided by the Neuman system model, we provide the primary, secondary and tertiary nursing care to help this patient adapt herself to the hemodialysis treatment, and to ameliorate her physical discomfort caused by uremia. We hope that the patient can establish a correct self-care method, enter social activities with a healthy attitude, and face long-term hemodialysis bravely.