運用羅氏適應模式於一位適婚女性尿毒症病人首次接受血液透析之照護經驗

Model on an Unmarried Young Woman Patient Undergoing First Time Hemodialysis

本個案報告是照護一位適婚女性尿毒症病人，首次接受血液透析之照護經驗。護理期間自2007年11月07日至2007年11月18日，筆者以羅氏適應模式為整體性評估，藉由身體評估、觀察及會談等技巧收集資料，加以分析整理，確立問題為體液過多、潛在性感染、焦慮、身體心像紊亂及角色扮演改變等健康問題。經由主動關懷個案需求，透過護理活動的介入，協助個案在生理調適、自我概念、角色功能、相互依賴各方面不斷適應，並獲得良好的支持系統，以減輕個案內心的焦慮，強化對疾病的了解，坦然面對血液透析治療，達到整體護理的目的。期望藉此次的護理經驗，與血液透析室的護理人員分享，日後照護類似此個案之臨床照護參考。

The case report describes, through interviews, a nurse's experience of caring for an unmarried young woman patient undergoing first time hemodialysis, from November 07 to November 18, 2007. Roy's Adaptation Model for complete evaluation was used to analyze and sort out the problems based on her physical assessment, along with close observation and intensive interviews with the patient, revealing that this patient had body fluid overload; the potential danger of infection, anxiety, body image disturbance and altered role performance were identified. Through a caretaker's active care and concern, the patient was finally helped in regard to: physical adjustment, enhanced self perception, role-relationship pattern and interdependence, while easing her anxiety. In addition, medical booklets were delivered regularly to improve her medical understanding. With the increasing cases of patients with end stage renal hemodialysis, this case report may provide some valuable information for the nursing staff in order to enhance their ability to provide more comprehensive care.