一位腹膜透析超過濾功能喪失病人改血液透析個案之護理經驗

Care Experience of a Patient with Peritoneal Dialysis Function Loss after Ultrafiltration of Transferred to Hemodialysis

10.29494/LN.201906_20(2).0006

林雯萱(Wen-Hsuan Lin)；林育如(Yu-Ju Lin)；葉淑敏(Shu-Min Yeh)

體液容積過量 ； 健康維護能力 ； 無望感 ； fluid volume excess ； health maintenance capability ； hopelessness

領導護理

20卷2期（2019 / 06 / 01）

72 - 83

繁體中文

本文是探討一位因腹膜透析超過濾功能喪失而轉為血液透析之護理經驗。護理期間從2016年2月9日至2016年2月16日。筆者藉由會談、傾聽、觀察、溝通及身體、心理、社會及靈性的整體性評估方式收集資料，並運用Gordon十一項健康功能型態進行評估架構來分析，確立個案主要健康問題有：體液容積過量、健康維護能力改變及無望感。透過體液容積過量處置，與個案建立良好信任關係之開端，進而提供水份控制及透析相關資訊與知識，並鼓勵表達治療改變的內心感受，傾聽、同理給予心理支持，藉由護理措施介入後，協助個案正向面對透析治療及水份控制，進而激發學習動機，重建維護健康能力，結果個案能規則血液透析治療，同時計劃健身運動，以恢復日常生活功能，回歸正常生活。期盼此護理經驗能提供護理同仁臨床照護參考，以提升護理品質。

This study discusses the caring experience of a patient with renal function loss and transformed from ultrafiltration of peritoneal dialysis to hemodialysis. The caring period was from February 9th to 16th, 2016. The author collected data by listening, observing, and communicating with the patient during interviews and conducting an overall evaluation of the patient's physiological, psychological, social, and spiritual dimensional measures. Subsequently, the patient's health issues were analyzed and determined based on Gordon's 11 Functional Health Patterns; the patient disclosed fluid volume excess, shown change in health maintenance capability, and hopelessness attitude. By treating the fluid volume excess, we developed trust with the patient, and also provided information on fluid regulation and dialysis knowledge. The patient was encouraged to express his opinions regarding the altered treatment method. Meanwhile, we showed empathy via listening and supporting the patient. The care interventions further enabled the patient to accept hemodialysis and learn about fluid control to improve his health maintenance capability. Consequently, the patient accepted and underwent regular hemodialysis and scheduled exercise with the expectation of returning to a healthy life. This study can hopefully serves as a reference for nurses to enhance their nursing quality.

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