一位腹膜透析病人併發切口疝氣之照護經驗

Experience in Caring for a Peritoneal Dialysis Patient Complicated by Incisional Hernia

本文敘述一位30歲男性進入腹膜透析治療，二個月後發生切口疝氣，術後暫改血液透析。個案因透析模式改變，其生活、工作需重新調適，出現焦慮不安等情緒反應。筆者於2023年8月9日至9月4日照護期間，運用Gordon十一項功能性健康型態進行整體性評估，確立健康問題為潛在危險性感染、知識缺失、焦慮。與個案建立信任的護病關係，提供個別性血管通路護理指導，增進自我照護能力；利用手機APP增加其對血液透析飲食認知改善高血磷；澄清血液透析過程相關疑慮，經由腎友經驗分享、親友陪伴，透析中教導放鬆技巧以音樂輔助治療降低焦慮。建議單位製作影音衛教影片或轉換透析模式前參觀血液透析室，循序漸進瞭解治療流程，協助個案調適並適應透析生活。

This article describes a 30-year-old man who entered peritoneal dialysis treatment. He developed an incisional hernia two months later and was temporarily changed to hemodialysis after the operation. Due to dialysis mode changes, the patient's life and work need to be readjusted, and emotional reactions such as anxiety and restlessness occur. During the care period from August 9 to September 4, 2023, the author used Gordon's 11 functional health patterns to conduct a comprehensive assessment and identified health problems as potentially dangerous infections, lack of knowledge, and anxiety. Establish a trusting nursing relationship with patients, provide individual vascular access care guidance, and improve self-care capabilities; use mobile APP to increase their understanding of hemodialysis diet and improve hyperphosphatemia; clarify doubts related to the hemodialysis process and share experiences with kidney friends, accompanied by relatives and friends, teaching relaxation techniques during dialysis and using music-assisted therapy to reduce anxiety. It is recommended that units make audiovisual health education videos or visit the hemodialysis room before switching to dialysis mode to understand the treatment process and help patients adjust and adapt to dialysis life.