運用Watson理論照護一位植入左心室輔助器病人接受血液透析之護理經驗

The Nursing Experience of Using Watson’s Theory to Care for a Patient with a Left Ventricular Assist Device Receiving Hemodialysis

本文描述一位心臟衰竭病人植入左心室輔助器，等待換心與接受血液透析雙重衝擊下之護理過程。於2020.10.23至2020.11.23護理期間，運用直接照顧、主動關懷、身體評估、行為觀察、會談、查閱病歷等方式，發現病人有無望感、透析相關知識缺失及導管潛在感染等問題。運用Watson關懷照護理論，協助病人及照顧者藉由透析治療計畫、心電圖監視器觀察、及個別性的照護，使其了解生理知識與學習自我照護，渡過等待換心與規則透析治療的過程，幫助病人轉為積極主動，接受病後生活改變並提升自我照護能力，找回自我價值感。建議日後可透過建立左心室輔助器（Left Ventricular Assist Device, LVAD）病人照護標準與提供護理人員相關教育訓練，提供個別性衛教模式，使病人能夠安全地接受透析治療，改善生活品質。

 

This article describes the nursing process of a heart failure patient who underwent left ventricular assist device implantation and waited for heart transplantation and blood dialysis under double impact. During the nursing period from 2020.10.23 to 2020.11.23, direct care, active care, physical assessment, behavioral observation, conversation, and medical record review were used to identify problems such as hopelessness, lack of knowledge about dialysis, and potential catheter infection. Using Watson’s caring theory, patients and caregivers were assisted through dialysis treatment plans, ECG monitoring observations, individualized care to understand physiological knowledge and learn self-care. They were able to get through the nursing process of waiting for heart transplantation and regular dialysis treatment, turning patients into active ones who accept postoperative life changes and improve their self-care ability and regain their sense of self-worth. It is recommended that in the future, LVAD (left ventricular assist device) patient care standards can be established and relevant education and training can be provided to nursing staff to provide individualized health education models so that patients can safely receive dialysis treatment and improve their quality of life.