1 運用悲傷輔導原則照顧一位血液透析患者喪友之護理經驗 * ** 98 5 23 98 6 23 Worden 關鍵詞 : 悲傷輔導 血液透析 無力感 2007 2008 2007 2007 end stage renal disease, ESRD 45,894 91.7 2007 2008 * ** 99 1 24 99 3 15 99 5 27 362 02 22193391 65343 lili40@ms59.hinet.net 100 12 10 3
2 Worden Holechek, 2004 2007 Polaschek, 2003 2007? 2006 2007 Wingard, 2005 2006 7~8 2005 Williams, Tell, Zheng, Shumaker, Rocco, & Sevick 2002 40~61 100 12 10 3
3 2009 2000 2009 Johnson, 2003 Lai & Good, 2005 Jiang, Chou, & Tsai, 2006 2000 2000 2008 2002 (Davidhizar & Giger, 2001) Miller 2000-1996 Miller, 2000 2002 grief Worden, 2001 Worden, 2001, 2004 100 12 10 3
4 2008 (2002) 91 2 250 mg/dl 18.6 mg/dl 2.4.6 11 98 5 23 51 89 98 5 23 98 6 23 1. 170 61.5 BMI 21 kg/m 2 61.5 59.5 2 BMI 21 kg/m 2 100 12 10 3
5 2. 7 2 5 4 3. 15 / 100 cc X CTR Cardio Thoracic ratio 0.45 4. 1. 2. 1. 3 2. 3. 51 100 12 10 3
6 Worden 100 12 10 3
7 1. 6/13 2. 6/23 2 7 S 1. 5/23 2. 5/26 2 3. 5/28 5 O 1. 5/26 2. 5/28 4 5/23 1. 2. 3. 5/28 4. 5. 6. 7. 6/13 6/18 6/20 6/23 7 100 12 10 3
8 1. 6/9 2. 6/16 3. 6/23 S 1. 5/26 2. 5/28 3. 5/28 4. 5/28 O 1. 5/26 2. 5/28 3. 5/28 5/26 1. 5/28 2. 20~30 3. 4. 5. 6. 7. 8. 9. 10. 6/9 6/16 6/20 6/23 100 12 10 3
9 1. 6/18 2. 6/23 S 1. 5/26 2. 5/28 3. 5/30 O 1. 5/26 2. 5/28 3. 5/30 4. 5/30 5. 5/30 5/26 1. 5/28 2. 3. 5/30 4. 5. 6. 7. 6/14 6/18 6/23 100 12 10 3
10 Worden 2006 5 218-30 2007 11 6662-667 2007 4 13 2007 7 4 http://www. kidney.org.tw/a95.gif 1996 4 127-34 2008 5 16 96 2008 6 18 http://www.doh.gov.tw/ 100 12 10 3
11 CHT2006/DM/DM2_p01.aspx?Class _no=25&now_fod_list_no=9281&lev el_no=2doc_no=53725 2008 55 590-96 2005 4 239-54 2009 128 2-6 2002 12 4327-333 2000 11 1 44-49 2000 921 11 479-84 2002 13 2146-150 2008 8 1 79-90 2007 11 2 140-52 2007 Worden, J. W. 2004 2002 Davidhizar, R. E., & Giger, J. N. (2001). Powerlessness. In M. L. Maas, T. T. Reimer, K. C. Buckwalter, & M. G. Titler. (ed.), Nursing care of older adults diagnosis, outcome, & intervention (pp. 679-695). Sydney: Mosby. Holechek, M. J. (2004). Acute renal failure and chronic kidney disease. In S. M. Lewis, M. M. Heitkemper, & S. R. Dirksen (Eds.), Medical-Surgical Nursing (6th ed., pp. 1210-1246). St. Louis: Mosby. Jiang, R, S., Chou, C. C., & Tsai, P, L., (2006). The Grief Reactions of Nursing Students Related to the Sudden Death of a Classmate. Journal of Nursing Research, 14(4), 279-285. Johnson, J. E. (2003). The use of music to promote sleep in older women. Journal of community health nursing, 20(1), 27-35. Lai, H. L., & Good, M. (2005). Music improves sleep quality in older adults. Journal of advanced nursing, 49(3), 234-244. Miller, J. F. (2000). Patient power resource. In J. F. Miller (ed), Coping with chronic illness: Overcoming powerlessness (pp. 3-19), Philadelphia: F. A. Davis. Polaschek, N. (2003). Living on dialysis: Concerns of clients in a renal setting. Journal of Advanced Nursing, 41(1), 100 12 10 3
12 44-52. Williams, S. W., Tell, G.. S., Zheng, B., Shumaker, S., Rocco, M. V., & Sevick, M. A. (2002). Correlates of sleep behavior among hemodialysis patients. American Journal Nephrology, 22(1), 18-28. Wingard, R. (2005). Patient education and the nursing process: Meeting the patient s needs. Nephrology Nursing Journal, 32(2), 211-215. Worden, J. W. (2001). Grief counseling and grief therapy: A handbook for the mental health practitioner (2nd ed.). New York: Springer. 100 12 10 3
13 Nursing Experience with Applying Worden s Theory to Helping a Hemodialysis Patient Cope with Bereavement Shu-Ching Leu Li-Ching Ma* Hsiang-Li Hsieh** Abstract The purpose of this article is to describe nursing experience with helping a hemodialysis patient cope with the grief of bereavement. The care period was from May 23 and June 23, 2009. Data was collected by the author through interviews, behavioral observations and records. The Grief Counseling Principles from Worden s Theory was applied to physical, emotional, intellectual, social, spiritual dimensions to evaluate patient care. Identified nursing problems included: disturbed sleeping pattern, grieving dysfunction and powerlessness. During the nursing process, the author used listening, companionship and empathy to provide the patient with continuous care and help him come to terms with the death of his girlfriend. The Four Tasks of Grieving were completed, enabling the patient to adapt to his new existence and focus on the future again. Key words: Worden s Theory, hemodialysis, powerlessness RN, Dialysis Unit, Department of Medicine, Cardinal-Tien Hospital Assistant Head Nurse, Nursing Unit, Cardinal-Tien Hospital* HN, Nursing Unit, Cardinal-Tien Hospital** Received Jan. 24, 2010 Revised Mar. 15, 2010 Accepted for publication May. 27, 2010 Correspondence Hsiang-Li Hsieh, No 362, Chung-Cheng Rd, Hsin-Tien City, Taipei County, Taiwan ROC. Telephone02 22193391 ext 65343 E-mail lili40@ms59.hinet.net 100 12 10 3