提升一位老年患者初接受血液透析自我照顧能力之護理經驗

Nursing Experience in Improving Self-Care Ability of an Elderly Patient undergoing Hemodialysis

本文描述一位老年糖尿病腎病變併慢性腎臟病第四期個案，選擇未來接受血液透析治療並預先建立動靜脈瘻管，在缺乏心理準備下即進入透析治療階段，治療初期因對自我照顧方式不了解，而引發焦慮情緒之護理經驗。護理期間自2020年2月18日至3月31日，筆者運用五大層面進行整體性評估與收集資料，確立個案有體液容積過量、健康維護能力失常、焦慮之健康問題；護理期間提供個別性照護措施，使個案進而適應老年透析生活。建議未來可將透析護理指導製作成衛教影片，並編製QR code條碼使透析患者及家屬能透過智慧型手機的普遍性與便利性即時獲取衛教資訊，對於強化其自我照顧能力及提升老年透析生活品質達雙重之效。

 

This article describes the nursing experience of caring an elderly diabetic nephropathy and stage 4 chronic kidney disease patient received arteriovenous fistula creation after decided hemodialysis treatment, leading him to long-term hemodialysis without preparation and felt anxious due to lack of self-care ability. During nursing period from February 18 to March 31, 2020, following the five major aspects, the problems included excessive fluid volume, ineffective health maintenance, and anxiety. During the nursing process, the author provided individual care to help patient adapted to the elderly dialysis life. Make dialysis health education video, generate QR code can help dialysis patients and families obtain health education information immediately through the universality and convenience of smartphones, which can have a dual effect on strengthening self-care ability and improving the quality of elderly dialysis life.