一位長期血液透析病人面臨其主要照顧者突罹癌症之護理經驗

Nursing Experience with a Regular Hemodialysis Patient Whose Primary Caregiver Was Unexpectedly Diagnosed with Cancer

本文為協助一位長期血液透析病人，因面臨主要照顧者突然罹患肝癌之衝擊，出現負面行為的照護經驗。自2009年11月6日至2010年4月30日收集資料及進行評估分析後，確立個案主要呈現一、無望感，二、體液容積過量，三、照顧者角色緊張等護理問題。因此根據Watson理論所提供的十項關懷照顧措施，鼓勵家屬間分享內心感受，並利用溝通技巧肯定及接受其正向和負向的感覺，減輕身心、社會，經濟等壓力，使個案能從以往擔任被照顧者的角色到接受其主要照顧者罹癌的事實，坦然面對彼此疾病的發展，面對未來的治療重新找回生命中的希望。期望本篇個案研究報告結果，能作為日後護理人員瞭解此類病人的經驗感受，以便提供適切諮詢及照護。

This report documented the nursing experience with a regular hemodialysis patient behaving in a negative way because the patient's primary caregiver was unexpectedly diagnosed with liver cancer. Observation and nursing care was lasted from November 6 2009 through to April 30, 2010. We analyzed this case and found that she was experiencing hopelessness, excess fluid volume, and caregiver role strain with her primary caregiver. The Jean Watson's theory of transpersonal caring was adopted to manage this patient by encouraging the family to share their feelings. We also used communication skills to affirm and accept the patient's positive and negative feelings as well as relieve physical, psychological and socioeconomic stress. The patient eventually came to terms with role of no longer being the care recipient as well as the fact that that the primary caregiver now had cancer and was able to accept the progression of their respective illnesses. This case report will hopefully provide nursing staff with a better understanding of these patients so appropriate consultation and support can be provided