照顧一位末期腎病患者轉換透析治療模式適應過程之護理經驗

本文為探討一位60歲女性末期腎病患者，在轉換不同透析治療模式時造成生理與心理的健康衝擊及適應困難之護理經驗。筆者於2020年1月6日至12月31日照護期間利用Gorden 十一項健康功能型態進行評估。確認個案主要護理問題為體液容積過量、焦慮和無望感。藉由相關護理指導使個案了解體液容積過量與飲食、水份的控制對改善水腫的重要性；提供個別性護理與個案共同規劃穿刺計畫、配合局部麻醉藥膏使用，降低因為穿刺引起之焦慮；傾聽個案不安，協助調整透析安排、鼓勵參與支持團體活動減輕其無望感。經由提供上述個別化護理照護，協助個案在轉換不同透析治療模式時可順利適應新生活型態。  <>This paper is to explore the nursing experience of the physical and psychological health impacts and difficult adaptation in a 60-year-old woman who changed different dialysis treatments in her end-stage of renal disease. Gordon’s 11 health function patterns were applied to assess the case from January 6th to December 31st, 2020. The main nursing problems of the case were excessive body fluid volume, anxiety, and hopelessness. The relevant nursing interventions were used to make the case understand the importance of the excess body fluid volume, control of diet, and water to lower edema. In order to reduce anxiety caused by punctures, the nursing care was to schedule the individual puncture plan and the treatment of local anesthetic ointment. We listened to her uneasiness, adjusted the dialysis arrangement, and encourage her to participate in the support group to reduce her hopelessness. By providing the above-individualized care, the patient successfully adapts to the new lifestyle in switching to different dialysis treatment modes.<>