運用ADOPT問題解決模式於一位兩次透析間體重控制不佳的血液透析個案

The Experience Using the ADOPT Problem-Solving Training Protocol in a Hemodialysis Patient with Poor IDWG Control

長期血液透析病患所面對的健康問題是多元複雜的，它涵蓋了生理、心理與社會層面。日常生活中患者要如何解決這些相關問題，方能在自己期望的生活型態中與疾病共存，是病患每日必須面對的重要課題。本文係運用ADOPT問題解決訓練方案照護一位透析間體重控制不佳的血液透析個案。照護期間為97年11月3日至97年12月8日。筆者藉此ADOPT模式，協助個案在面對日常生活中不同情境問題時，依循ADOPT問題解決過程來處理其疾病與治療相關問題，也發現此照護模式能有效增進個案問題解決能力。筆者期望這個以理論為根基的照護方案，可作為建立慢性病照護模式之參考。

The health problems of hemodialysis patient are complex, involving physical, mental and social aspects. Those with chronic conditions must be able to resolve disease and treatment problems on their own expectation in order to maintain life quality. This case report describes how the authors applied the ADOPT (Attitude, Definition, Open mind, Planning, Try it out) problem-solving training model to care for a hemodialysis patient with poor interdialytic weight gain (IDWG) control. Nursing care was provided to this patient from November 3rd to December 8th, 2008. This case demonstrated ADOPT model efficacy at improving the patient's problem solving abilities in various daily life situations. The authors hope this theory-based intervention can help establish an innovative and effective care model for patients with chronic conditions.