一位腹膜透析患者併發腹股溝疝氣之照護經驗

The Nursing Experience for Assistance a Peritoneal Dialysis Patient with Inguinal Hernia

本篇主要描述協助一位50歲尿毒症個案在接受透析治療後，發生腹膜透析機械性合併症之腹股溝疝氣，承受生、心不適的壓力衝擊及隱藏個案背後心靈不安之護理經驗。筆者於2011年7月9日至10月1日護理期間藉由觀察、會談、身體評估進行整體性護理評估，並歸納分析出個案有術後傷口疼痛、知識缺失及心靈困擾等主要健康問題。護理期間以護理專業技能，減輕疝氣修補術後傷口疼痛增進術後舒適，針對個案對疾病與治療之疑惑，主動提供疾病、治療與自我照護資訊，澄清個案問題並增進個案自我照護知識及技能。護理過程中，以傾聽、陪伴與關懷態度協助個案透過信仰，調適因疾病與治療產生之心、靈不適而獲得心靈平安，並坦然面對與勇於接受腹膜透析治療，以擴展生命的質與量。希望以此護理經驗，提供臨床護理人員作為照護類似病人之參考。

This case report describes the nursing experience from caring for a peritoneal dialysis patient suffering from inguinal hernia. The author provided nursing care from July 9 to October 12 in 2011 and used observational methods, interviews and physical assessment to collect the data. The patient's health problems included pain, knowledge deficit, and spiritual distress. Holistic and patient-centric nursing care plans were proposed based on the patient's problems. During the process, we provided professional nursing care using listening, companionship, and caring behavior. The patient was given help with physical pain relief, improving self-care skills, and resolving spiritual conflict through compassion, patient education, religious support and nursing care. The patient ultimately came to accept the disease and peritoneal dialysis treatment, enhanced his self-care abilities and skills, attained physical and psycho-spiritual comfort, and improved his quality of life. By sharing these nursing care experiences with other nurse colleagues, we hope comprehensive care can be provided to other patients with similar health problems.