運用周全性老年評估照護一位高齡腹膜透析病人的護理經驗

Nursing Experience of a Senior Peritoneal Dialysis Patient with a Comprehensive Geriatric Assessment

本文探討一位73 歲的高齡出家個案，因高血壓、慢性腎衰竭、器官老化就醫，經診斷為尿毒症，病人在瞭解各種腎臟替代療法後，選擇腹膜透析治療。筆者於2017 年12 月8 日至2018 年1 月20 日照護期間，運用周全性老年護理作為評估工具，藉由觀察、傾聽、會談、身體評估方式進行資料收集，確立個案有焦慮、知識缺失、營養少於身體所需等三項主要健康問題。在照護過程中以傾聽、陪伴、關懷及支持減緩焦慮，提供相關知識、護理指導及居家訪視增加信心，藉由跨部門診斷、諮詢與衛教補充個案營養所需。在整體性及持續性照護模式下，使個案在短期內學會獨立執行腹膜透析治療，進而改善其生活品質，成為一位高齡志工。

 

This article explores a 73-year-old nun, who was diagnosed with uremia due to hypertension, chronic renal failure, and organ aging. The patient chose peritoneal dialysis treatment after learning the various renal replacement therapies. During the period of care from December 8, 2017 to January 20, 2018, the author used a comprehensive geriatric assessment (CGA) as a research tool. Data was collected through observation, listening, interviews, and physical assessment to assess the case, and found that the case had three major health problems: anxiety, lack of knowledge, and less nutrients than the body needs. In the process of care, anxiety was reduced by listening, companionship, care and support. Relevant knowledge, nursing guidance and home visits were provided to increase her confidence and, nutritional needs were supplemented by cross-departmental diagnosis, counseling and health education. Under the holistic and continuous care mode, the case will learn to perform peritoneal dialysis treatment independently within a short period of time, thereby improving the quality of life and becoming a senior volunteer.