照顧一位罹患梅毒之透析病人的護理經驗

Nursing Experience of a New Hemodialysis Patient with Syphilis

本篇報告是分享照顧一位初期接受血液透析的病人，其因得知罹患梅毒，而產生焦慮、罪惡感及無助行為的護理經驗。筆者於95年5月18日至95年7月20日照護期間，藉由會談、觀察、家屬訪談、身體評估等方式收集資料，運用Gordon11項健康功能型態評估，發現病人有體液電解質不平衡－－高血磷、健康尋求行為、抉擇衝突等健康問題。筆者透過醫療團隊合作與討論，進行個別性照護，主動關懷、陪伴及傾聽，鼓勵病人表達心中想法，與病人共同擬定計劃，依飲食日誌與飲食衛教、藥物指導，協助病人改善高血磷、提供梅毒自我照顧方法、並協助解決疾病帶給家庭的壓力及問題，改善夫妻之間關係，使病人恢復自信，獲得最佳身、心、社會適應。

This report aims to share the nursing experience of caring for a new hemodialysis patient suffering from anxiety, guilt and helplessness after testing positive for syphilis. From May 18 to July 20, 2006, we collected data by observing and interviewing the patient and his family. After applying Gordon's 11 health assessment and examination methods, three problems were found including hyperphosphatemia, health-seeking behavior and decisional conflict. We resolved the patient's problems via medical cooperation and discussion, active individualized care, companionship and listening. We also encouraged the patient to express his thoughts. Working with the patient, plans were drawn up to improve hyperphosphatemia using dietary diary, diet education and medical guidance. We also provided self-care methods for syphilis to the patient, helped resolve the pressure and problems that the diseases caused to the family and also helped improve the relationship between husband and wife. With our assistance, the patient regained his self-confidence and was able to adapt physically, psychologically and socially.