血液透析患者的復原力與社會支持

The Resilience and Social Support systems for Hemodialysis Patients

血液透析治療對病患生理、心理、社會、日常生活品質影響為永久性。慢性腎臟病其腎功能衰退的速率則受病患對疾病的認知、服藥的遵從性、飲食的控制、壓力調適、治療模式及其他特殊情況等影響，病程進展到末期腎臟病時，病患就必須接受透析的治療。實務經驗中發現，患者在接受血液透析治療時，會形成病患的另一種壓力源，例如：生活形態改變和工作能力等多方面的內在或外在影響與衝擊，且伴隨透析治療過程而來的併發症也常使患者倍感生命受威脅，而引發焦慮、憂鬱，甚至亦有病患以自殺來結束生命。因為復原力與社會支持均有助於病患面對壓力的適應和處理，因此若能夠了解患者本身的復原力，將有助於患者接受血液透析治療；而提供適當的社會支持資源，也能幫助患者回歸生活，降低其憂鬱。希望藉此篇文章提供給家屬、醫療護理同仁及未來研究者之參考學習依據。

Hemodialysis therapy has a significantly adverse influence on patients physically, mentally and socially. More often than not, patients are inadequately prepared to cope with their chronic disability and often fail to adhere to instructions regarding therapy, medications and dietary control. As a consequence, progressive deterioration to end-stage renal disease (ESRD) is frequently inevitable and decisions regarding appropriate renal replacement therapy have to be made. Patients with ESRD are usually under a lot of stress, such as: the significant disruptions to their way of life and job performance. Depression is known to be prevalent in these patients and some are even known to have suicidal thoughts or tendencies. Patients who are unable to overcome their difficulties have poor outcomes and quality of life, while those who show resilience of spirit adapt better and have more favorable outcomes. Health care workers can get involved by helping patients cope with their personal as well as medical problems by encouraging them to build up resilience and by facilitating access to social support systems in order to minimize disruptions to their work and lifestyle. Hopefully, this paper may lay a good foundation for patients and their families, dialysis nurses and for future researchers interested in this issue