協助一位初次血液透析患者建立長期透析生活之護理經驗

Nursing Care Experience of Assisting an Initial Hemodialysis Patient to Establish Long-term Dialysis Life

本文旨在探討一位血液透析患者初次接受透析治療之護理經驗，護理期間自2019年7月19日至9月30日，利用Gordon十一項健康功能型態進行護理評估，藉由會談、觀察、身體評估及查閱病歷方式收集資料，確立個案主要的護理問題為潛在危險性感染、無效性健康管理及無力感。照護期間依個案之個別性，運用主動關懷、同理心及傾聽方式，鼓勵個案表達內心感受，提供血液透析相關知識、飲食指導及衛教單張來協助個案建立正確知識，建立良好飲食習慣及提升自我照顧能力，並以正面態度來面對長期透析。藉由護理指導方式和醫療團隊合作及家庭支持系統的發揮，讓個案成功接受與建立長期透析生活，進而回復往常生活與工作。

The purpose of this article is to describe the nursing experience of assisting an initial hemodialysis patient to establish long-term dialysis life. The nursing period was from July 19 to September 30, 2019. Data was collected by observation, interview, physical examination, and chart review. Gordon´s 11 functional health patterns were applied for systemic evaluation. Three nursing problems were identified including risk for infection, ineffective self-health management, and powerlessness. During the nursing period, according to the individuality of the patient, use active caring, empathy and listening methods to encourage patient to express needs and inner feelings, provide hemodialysis related knowledge, dietary guidance, and education leaflets to help patient build correct knowledge, establish good eating habits, increase self-care ability, and be positive attitude to face long-term hemodialysis. With the help of nursing guidance, medical team cooperation and family support system, the patient can successfully accept and establish a long-term dialysis life, and then patient resumed his ordinary life and work.