照顧一位血管通路功能不良的血液透析病患之護理經驗

The Nursing Experience of Caring for a Hemodialysis Victim with Poor Vascular Access Function

本篇是探討一位49歲罹患末期腎病症候群的男性病患，在接受血液透析時因血管通路功能不良，面臨血管重建與血管訓練之壓力與衝擊。護理期間自92年4月1日至92年10月30日，過程運用Gordon十一項健康功能評估，並藉由直接護理、觀察會談等方式收集資料，加以分析整理。個案因面臨血管功能不佳的壓力，其健康問題包括：焦慮、身體心像紊亂、特定知識缺失。筆者在護理過程中採傾聽、同感心、給予個案鼓勵與支持，協助維持生理及身體功能，尋求家人支持使其重獲自信心，並提供相關資訊使個案瞭解居家照顧的重要性。雖然血液透析個案屬於門診個案，但利用各種方式執行個別化且持續性的護理，如此才能使個案視血液透析治療為日常生活的一部份。

This article is about a 49-year-old man who suffered from end stage renal disease (ESRD), stress, and the impact of vascular rebuilding and vascular training due to poor vascular access function while undergoing hemodialysis. During nursing care from Apr.1'92 to Oct.10'92, Gordon's 11 Health Function Evaluation was performed and data was collected via direct nursing, observatory interview, and analysis. His health problems, due to the stress of poor vascular function includes: anxiety, change in body image, and loss of specific knowledge. The author listened, gave sympathy, encouragement and support, as well as helped maintain physiologic and physical functions with his family's support in order to rebuild his self-confidence and provided related information for him to understand the importance of care-at-home. The hemodialysis case is attributed to the outpatient case in which a nurse performs individual and persisting care by various means so that the victim will accept hemodialysis treatment as a part of everyday life.