運用多媒體教材照護一位初次血液透析病人之護理經驗

Nursing Experience of Using Multimedia Materials to Care a Patient in First Hemodialysis

本文描述一位因跌倒導致傷口癒合不佳引發敗血性休克的病人，間接造成腎功能不可逆損傷，需面臨長期透析的衝擊下出現焦慮引發筆者關注。護理期間為2021年1月27日至2021年2月7日，透過身體評估、觀察、病歷查閱等方式進行資料收集，並藉由整體性評估個案之生理、心理、社會及靈性四大層面，確立護理問題一、體液容積過量/與疾病導致無法有效排出水分有關、二、潛在危險性感染/與管路留置有關、三、焦慮/與需面臨長期透析有關。護理期間筆者對於體液容積過多提供個別性衛教增加個案自我管理能力，衛教期間融入多媒體教材，降低個案面臨初次透析的焦慮及疑問，提升管路照護學習成效。考量台灣主要照顧者有部分為新住民，建議未來發展多媒體教材時，應增加其他語言發揮更大效益。

This article discusses the nursing experience of caring for a patient who developed septic shock due to impaired wound healing, resulting in irreversible renal damage. The patient also experienced severe anxiety as a consequence of long-term dialysis. The nursing care period extended from January 1, 2021, to February 7, 2021. Data were collected through observation, direct care, physical examination, medical record review, and proactive concerns. The patient's physical, psychological, social, and spiritual statuses were assessed using a combination of observation, assessment, interviews, and written communication. The primary health problems identified were fluid overload, risk of infection, and anxiety. To address fluid overload, individualized health education was provided, which improved the patient’s self-care abilities. The use of multimedia materials during the initial dialysis sessions helped reduce the patient's anxiety and enhanced learning and care effectiveness. Considering that many primary caregivers in Taiwan are new immigrants, incorporating additional languages into multimedia materials could provide greater benefits.