照顧一位感染愛滋病毒的長期血液透析病患之護理經驗

A Nursing Care Experience of a Long-term Hemodialysis Patient with Human Immunodeficiency Virus

本文是探討一位因長期血液透析而感染愛滋病毒之個案的護理過程，個案因輸血治療意外感染愛滋病毒而須面臨生理、心理、社會三方面的壓力，產生適應困難的問題。筆者於93年5月1日至94年1月31日護理期間直接參與每次血液透析之照護，並透過會談、觀察、傾聽等技巧收集資料，並運用羅氏適應模式進行護理評估，處理個案感染愛滋病毒後之護理問題，包括：高危險性感染、營養功能障礙、無望感、身體心像紊亂等。護理過程中主要運用關懷、同理心及接受等技巧與個案建立互信之護病關係，提供適當且連續的護理與關懷，讓個案渡過感染愛滋病毒後所面臨的衝擊，使其身、心、社會得到正向的適應。

This article explored the nursing experience of a long-term hemodialysis patient with human immunodeficiency virus (HIV). This patient was accidentally infected with HIV through blood transfusion. When the diagnosis was confirmed, he could not adapt but rather was disturbed in three aspects: his physiology, psychology and social interactions. The patient's nursing process occurred from 1st of May 2004 to the 31st of January 2005. Observing, listening and conversation skills were used to collect related data. High risk of being infected, malnutrition, hopelessness and body image disturbance were evident from the client's situation. According to his adaptation needs, Roy's nursing model was applied to the patient. By sincere concern, sympathy and acceptance during the nursing process, a trusting relationship between the author and the client was established. Therefore, the patient could better deal with the impact of HIV infection and positively adapt to further treatment. The author shared this experience as reference for nurses who will deal with similar clients.