協助一位末期腎臟病患者由血液透析治療轉作腹膜透析之護理經驗

Nursing Care of an End-Stage Renal Disease Hemodialysis Patient’s Acceptance of Peritoneal Dialysis

本文為探討一位血液透析末期腎臟病患者，在透析廔管功能多次阻塞，而面臨抉擇轉作腹膜透析治療方式的過程中，因無法預期治療改變的結果、缺乏相關資訊，造成生理、心理方面衝擊的護理經驗。護理期間為2006年10月20日至2007年3月5日，運用Gordon十一項健康功能評估，確立個案有知識缺失、焦慮、急性疼痛等護理問題。在護理過程中採傾聽、給予個案鼓勵與支持，提供適當的護理措施，改善個案之身心問題，協助個案在生理調適減輕術後疼痛，尋求家人支持使其重獲自信心，提供相關的護理指導與諮詢，透過持續性、整體性的個廔管理護理模式，協助病患及家屬順利渡過此次經驗，早日恢復其角色功能。

This article is about an end-stage renal failure hemodialysis patient who was forced to switch to peritoneal dialysis because of multiple episcopes of fistula thrombosis. The unexpected change of therapy caused psychological and physiological maladjustment because of insufficient knowledge and the unpredictable outcome of the treatment. During the period of nursing care, from the 20th of October 2006 to the 5th of March 2007, Gordon’s 11-item Function Health Pattern Evaluation was used to assess this patient’s needs. The patient’s health problems included: deficient knowledge, anxiety and acute pain. The author listened, encouraged and supported the patient, and Saw that the nursing care focused on these problems. The relationship between the treatment of psychological and physiological issues can be improved. His family supported the rebuilding of his self-confidence; they provided related information. Continuous and comprehensive nursing care of returned demon was used to evaluate the patient’s ability to care for himself prior to discharge.