一位因遺傳性多囊腎首次接受血液透析治療病患之照護經驗

Care Experience of a Patient with Polycystic Kidney Disease Receiving Hemodialysis for the First Time

本文旨在陳述一位罹患遺傳性多囊腎疾病患者，首次接受血液透析治療之照護經驗。護理期間自2010 年7 月12 日至2010 年7 月30 日，護理過程中以Waston 人性關懷照護模式為資料收集架構，經由身體評估、觀察、深度訪談、病歷查閱等技巧收集資料，發現個案有疼痛、潛在危險性傷害、無望感、疲憊以及家庭因應能力失調等健康問題。筆者以Watson 關懷照護的精神為指引，給予其關懷的知覺與經驗，並與個案建立良好互信關係。藉由心靈的交會進入彼此的現象場，強化對疾病的認知，及具備表達自我與認同個體重要性的能力，坦然面對疾病的發展，陪同個案及家屬走過疾病的陣痛期，並協助個案適應血液透析為生活的一部份。期藉此護理經驗提供相關臨床護理人員，在照護此家族遺傳性疾病病人，首次接受血液透析可能遇到的相關問題之參考。

This article aims to describe the care experience for a patient with polycystic kidney disease receiving hemodialysis for the first time. From July 12 to July 30, 2010, the author assessed the case via physical examination, observation, in-depth interviews and medical record reviews to collect information in accordance with the Watson’s Theory of Nursing. The author identified some health problems in the case including pain, hopelessness, tiredness and dysregulation of family response ability. The author provided care, established a good relationship of mutual trust, built up understanding with the patient through spiritual communication and strengthened understanding of the disease. In addition, the author helped the case to express himself, realize the importance of the individual, face the disease with an open-mind, overcome the illness adaptation period with the support of other family members, and become used to hemodialysis. The author would like to share the care experience for a patient with polycystic kidney disease receiving hemodialysis for the first time with other clinical nurses.