從腹膜透析衛教指引到臨床實務

From Peritoneal Dialysis Education Guidelines to Clinical Practice

腹膜透析衛生教育，影響腎友居家透析的生活品質和存活率，其重要性不言可喻，如何由淺入深的引領病人達成學習目標，更是腹膜透析工作者的希望及義務，雖然國際腹膜透析協會早在2006年即已發表衛教指引建議，透過完善的衛教流程可以達到更好的衛教成效。然而，臨床上對於如何執行透析衛教過程並未重視；截至目前為止國內並未有相關介紹此指引之內容以及臨床上運用結果之文章。因此，本文闡述國際腹膜透析衛生教育指引，包括衛教內容、空間軟硬體設備、衛教時間及模式等層面，透過衛教後評值及定期的再訓練計畫，持續關注病人自我照顧能力的水準，適時的居家訪視更可了解病人學習及適應的結果。同時，綜合作者多年來的實務經驗，提出衛教指引與臨床的建議，期盼能和所有透析工作者分享，一起為增進腎友自我管理及自我照顧而努力。

Peritoneal dialysis (PD) education, which has been shown to impact life quality and survival rates, is thus crucial to patients with end-stage renal disease. As medical workers in the PD field, it is our hope and obligation to lead every patient to achieve their individual self-care goals. Although the International Society of Peritoneal Dialysis (ISPD) published guidelines for peritoneal dialysis training in 2006 to help build a comprehensive educational program for better outcomes, how to implement related education programs has not yet been taken seriously by clinical health workers. In Taiwan, no articles introducing these guidelines and no report on the clinical implementation of these guidelines have been published. Thus, this article was written to describe the ISPD guidelines on PD education, including education content, space requirements, soft / hard equipment needs, training hours, and mode. Medical workers may use evaluation and periodical retraining to continuously monitor the selfcare ability of patients. Aided by timely home visitations, learning outcomes and patient adaption may be followed comprehensively. Furthermore, to help patients under PD strengthen their capabilities of self-management and self-care, practical training suggestions based on the practice experience of our PD center are also included in this article as references for all medical workers in the PD field.