86 * 2009 11 6 2010 4 30 Watson 2011 2010 4.9 29.7 Roche, 2009 * 100 8 15 100 9 21 100 12 5 112 201 02 28757028 tyjchen@vghtpe.gov.tw 101 12 11 4
87 2007 Watson Krespi, Bone, Ahmad, Worthington, & Salmon, 2008Eghbali, Shahqolian, Nazari, & Babaee 2009 28~78 5 2008 Lindberg, Wikström, & Lindberg, 2011 Lata1, Albuquerque, Carvalho, & Lira, 2008 2006 Mystakidou, Tsilika, Parpa, Galanos, & Vlahos, 2007 2009 101 12 11 4
88 2011 Honea et al., 2008 Caruso, Cisar, & Pipe, 2008 Watson, 1988 Watson Watson, 2009Watson 1988 40 30 C 20 2009 10 C Child-Turcotte-Pugh Class C 12 2010 4 101 12 11 4
89 2009 11 6 2010 4 30 Watson 1. 130/86 mmhg 74 / 24~26 / 2009 11 X-ray cardiothoracic Ratio 0.49 0.5 SpO2 96 36 2 ++ 1~2 500 cc/ 3 43.3 5 2.1 2. 155 43.3 BMI 18.2 kg/m² ++ 2009 11 30.6 gm/dl 3.9 gm/dlblood urea nitrogen, BUN89 mg/dl creatinine, Cr13.8 mg/dl 10 mg/dl4.4 mg/dl 132 mg/dl 70 mg/dl normalized protein catabolic rate PCRn1.6 101 12 11 4
90 3. 1~2 1~2 500 cc/ 5 ++ 4. 5. 7 8 1 2 30~45 24 101 12 11 4
91 3 / / / / 2009.11.06~2010.03.22 1/1 3/22 S 1 S 2 1. 2. 2.1 3. 11/20 101 12 11 4
92 1. 11/20 12/21 S3 2. 1/1 12/11 S4 1. 1 2. 2 3/ 22 1. O1 2. 3. O2 2 O3 45 101 12 11 4
93 / 2009.11.06~2010.01.29 ~ 12/2 2.1 Kg 1 /29 S1 S2 S3 1~2 500 cc 11/20 S4 O1 130/86 mmhg 74 / 24 / 90/50 mmhg O2 C/T Ratio 49 3 I/O+1,500 O3 1. 2. 1.1 2.1 1. 2. 3. 1. 2. 600 cc 3. 30 4. 12/2 2.5 12/2 120/76 mmhg 72 / 17 / 12/16 101 12 11 4
94 2 ++ O4 Albumin 3.9 mg/dl HCT 30.6 gm/dl BUN 89 mg/dl Cr 13.8 mg/dl Na 137 mmol/l SpO2 96 O6 O7 46.7 11/20 43.3 3.4 O8 4 7 5. 6. 2~2.5 Kg 12/30 1. 2 Kg 2. 30 1/15 3. 30 2 Kg 1/29 101 12 11 4
95 / 2009.11.06~2010.04.30 11/11 2/10 4 /30 S1 11/20 S2 12/14 S3 12/14 S4 1/22 S5 O1 O2 1. 2. 7 3. 4. 11/11 11/20 12/30 11/22 2/26 7 Yr-90 sirt 3/12 4/30 5 101 12 11 4
96 Watson 2011 7 29 99 2011 9 20 http://www.doh. gov.tw/cht2006/dm/dm2_2. aspx?now_fod_list_no=11962&class_ no=440&level_no=4 2009 9 17-11 2008 7 128-32 2011 58 343-52 2006 11 4383-391 101 12 11 4
97 2007 6 123-36 Caruso, E. M., Cisar, N., Pipe, T. (2008). Creating a healing environment: An innovative educational approach for adopting Jean Watson s theory of human caring. Nursing Administration Quarterly, 32(2), 126-132. Eghbali, M., Shahqolian, N., Nazari, F. & Babaee, S. (2009). Comparing problems of patients with chronic renal failure undergoing hemodialysis and peritoneal dialysis referring to medical university s hospitals. Indian Journal of Medical Research, 14(1), 1-5. Honea, N. j., Brintnall, R., Given, B., Sherwood, P., Colao, D. B., Somers, S. C., & Northouse, L. L. (2009). Putting evidence into practice: Nursing assessment and interventions to reduce family caregiver strain and burden. Clinical Journal of Oncology Nursing, 12(3), 507-516. Krespi, M. R., Bone, M., Ahmad, M., Worthington, B., & Salmon, B. (2008). Hemodialysis patients evaluation of their lives. Turkisb Journal of Psychiatry, 19(4), 1-7. Lata1, A. G. B., Albuquerque, J. G., Carvalho, L. A. S. B. P., & Lira, A. L. B. C. (2008). Nursing diagnosis in adults on hemodialysis. Acta Paul Enferm, 21(Número Especial) 160-163. Lindberg, M., Wikström, S. B., & Lindberg, P. (2011). A behavioural nursing intervention for reduced fluid overload in haemodialysis patients. Initial results of acceptability, feasibility and efficacy. Journal of Nursing and Healthcare of Chronic Illness, 3(2), 87-98. Mystakidou, K., Tsilika, E., Parpa, E., Galanos, A., & Vlahos, L. (2007). Caregivers of advanced cancer patients: Feelings of hopelessness and depression. Cancer Nursing, 30(5), 412-418. Roche, V. (2009). The hidden patient: Addressing the caregiver. American Journal of the Medical Sciences, 337(3), 199-204. Watson, J. (1988). Nursing: Human science and human care - a theory of nursing (pp 1-8). New York: National League for Nursing Press. Watson, J. (2009). Caring science and human caring theory: Transforming personal and professional practice of nursing and health care. Journal of Health and Human Services Administration, 31(4), 466-482. 101 12 11 4
98 Nursing Experience with a Regular Hemodialysis Patient Whose Primary Caregiver Was Unexpectedly Diagnosed with Cancer Tzu-Yin Chen Hsin-Ling Tai Fen-Chu Chen* Abstract This report documented the nursing experience with a regular hemodialysis patient behaving in a negative way because the patient's primary caregiver was unexpectedly diagnosed with liver cancer. Observation and nursing care was lasted from November 6 2009 through to April 30, 2010. We analyzed this case and found that she was experiencing hopelessness, excess fluid volume, and caregiver role strain with her primary caregiver. The Jean Watson s theory of transpersonal caring was adopted to manage this patient by encouraging the family to share their feelings. We also used communication skills to affirm and accept the patient s positive and negative feelings as well as relieve physical, psychological and socioeconomic stress. The patient eventually came to terms with role of no longer being the care recipient as well as the fact that that the primary caregiver now had cancer and was able to accept the progression of their respective illnesses. This case report will hopefully provide nursing staff with a better understanding of these patients so appropriate consultation and support can be provided. Key words: regular hemodialysis, primary caregiver, cancer RN, Department of Nursing, Taipei Veterans General Hospital RN, Department of Nursing, Taipei Country Hospital* Received Aug. 15, 2011 Revised Sep. 21, 2011 Accepted for publication Dec. 5, 2011 Correspondence Tzu-Yin Chen, No. 201, Sec. 2, Shih-Pai Rd., Taipei. Telephone02 28757028 E-mail tyjchen@vghtpe.gov.tw 101 12 11 4