運用羅氏適應理論照顧一位初次接受血液透析患者之護理經驗

Nursing Care Experience of a First Hemodialysis Patient Using the Roy's Theory

本文是探討一位末期腎病變患者於初次接受血液透析治療過程中，面臨身、心及社會改變所引發的護理問題。筆者藉由觀察及會談技巧收集資料，並運用羅氏適應模式針對個案在生理、自我概念、角色功能及相互依賴進行護理評估，護理期間自97年2月21日至97年4月15日，確立個案有四個護理問題：(1)營養不均衡：少於身體需要(2)焦慮(3)無效性健康維護能力(4)潛在危險性感染等健康問題。筆者在護理過程中運用傾聽、陪伴及同理心，給予個案及家屬鼓勵、支持及持續性照顧，並利用護理專業知識，依個案之個別性提供血液透析相關知識、腎友的經驗分享、飲食治療及自我照顧技巧等措施。個案透過這些護理措施，能坦然面對血液透析治療、減輕焦慮及提升自我照顧能力。家屬也能配合飲食治療原則來準備飲食並且參與照顧，讓個案能成功地適應血液透析的新生活。

This article is to explore what the physical, psychological and social issues when the patient has diagnosis of end stage of renal disease and currently undertaking hemodialysis at the first time. The author applied close observation and interview technique to collect data and assess the patient by means of Roy's theory during the nursing period from Feb 21 to Apr 15, 2007. Establish what the four major nursing problems are the nutrition is imbalanced: is short in the bodily need, anxiety status, invalid health maintenance ability, the potential danger of infections, etc. The author utilizes in the nursing process used attentive listening, accompanies and sympathy, giving the case and the family member encourages, the support and the persisting care and using the nursing specialized knowledge, offering lack of knowledge of hemodialysis according to individual the case, peer group counseling to share experience, diet treatment and self-care technique and other measures. The case can face the hemodialysis treatment, reduce confidently anxious and enhanced the self-care ability after these nursing measures. The family members can also coordinate with medical workers to prepare the diet by using the diet principle of treatment, and participate in the care, enables the case to adapt the hemodialysis new life successfully.