協助一位老年患者面臨終生血液透析無力感之護理經驗

The Nursing Experience of Assisting an Elderly Patient with Helplessness in Undergoing Hemodialysis

本文描述一位老年女性患者因急性腎損傷後進展至末期腎病變，需面臨長期血液透析治療之護理經驗。護理期間自2017／4／11至6／30，照護時發現個案缺乏家庭支持而獨自承受生、心理及社會層面等壓力，故筆者運用觀察、會談、查閱病歷和電訪收集資料，依Gordon十一項健康功能型態評估，確立有舒適障礙、潛在危險性感染與無力感等健康問題；護理過程中深入了解個案內心想法，透過個別性護理措施、尋求社會支持，並將家屬列入照護對象，以強化家庭支持系統，同時亦藉由腎友交流，協助以正向態度將透析治療融入晚年生活，使其及早渡過壓力調適過程。

This article describes the nursing experience of caring an elderly female patient suffering from acute kidney injury (AKI) initially, and later progressed to end-stage renal disease (ESRD), leading her to receive long-term hemodialysis (HD). During the nursing period from April 11 to June 30 in 2017, we found that the patient lacked family support and was under physical, psychological, and social pressures alone. Therefore, observation, conversation, medical record review, and telephone interview were used to gather information and assess the health problems, following Gordon's 11 functional health patterns assessment tool. The problems included comfort impaired, risk of infection, and sense of helplessness. During the nursing process, the author deeply understood the patient's inner thoughts, arranged individualized nursing care interventions, sought social support, enrolled her family members as a part of care recipients to strengthen the family support system, and furthered the exchange of experience between dialysis patients. Through these measures, the author helped the patient face dialysis treatment with a positive attitude and overcome difficulties with efforts.