照顧一位未婚女性病患面對血液透析治療之護理經驗

Nursing Experience from Taking Care of Single Female Patient Receiving Hemodialysis Treatment

本文是探討一位未婚女性病患因服用中藥而罹患末期腎病首次接受透析治療所引發的壓力與衝擊。護理期間自民國98年6月30日至8月1日，藉由觀察、會談、傾聽等方式蒐集資料，運用Gordon十一項健康功能評估，確立個案有：潛在危險性感染、知識缺失、身體心像紊亂、角色扮演改變等護理問題。藉由提供照護手冊以加強個案對疾病的認知與照護技巧，及改善導管留置所造成身體心像紊亂，並經由主動關懷引導個案表達自身感受，減緩因害怕透析而未能完成人生另一階段之擔憂，成功的協助個案因應透析所面臨的困擾，且能以正面的態度來面對疾病及後續治療。鑑於末期腎病患者接受透析治療日漸增多，筆者藉此個案報告與護理同仁分享照護經驗。

The report examined the stress and impact on a single female with end-stage renal disease caused by the taking of traditional Chinese medication receiving hemodialysis treatment for the first time. During the nursing period from June 30, 2009 to August 1, 2009, data was collected through observation, interview and attentive listening. The data was evaluated with the Gordon health function model and the woman was confirmed to be experiencing several health problems. The problems included potential risk of infection, knowledge deficit, body image disturbance and change in role etc. Patient self-care handbook was provided as part of the integrated nursing care in order to strengthen the knowledge of disease and skill of self-care. The handbook also helped the patient cope with the body image disturbance caused by catheter installation. The patient was given active support to express her feelings and alleviate her fear of hemodialysis preventing her from realizing her life's ambitions. Nursing care was successful in helping the patient deal with the inconvenience of hemodialysis, accept the disease and approach further treatment with a positive attitude. With an increasing number of patients with end-stage renal disease now undergoing hemodialysis, this report is the author's way of sharing nursing experience with other colleagues in nursing.