{"title":"Review of Zhang & Zhang (2022): Introducing Chinese Linguistics: A handbook for Chinese language teachers and learners","authors":"H. Luo","doi":"10.1075/csl.00030.luo","DOIUrl":"https://doi.org/10.1075/csl.00030.luo","url":null,"abstract":"","PeriodicalId":31271,"journal":{"name":"Tai Wan Jiao Yu She Hui Xue Yan Jiu","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83716032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Review of Yuan, He & Hu (2023): Pedagogical Grammar and Grammar Pedagogy in Chinese as a Second Language","authors":"Zheng-sheng Zhang","doi":"10.1075/csl.00031.zha","DOIUrl":"https://doi.org/10.1075/csl.00031.zha","url":null,"abstract":"","PeriodicalId":31271,"journal":{"name":"Tai Wan Jiao Yu She Hui Xue Yan Jiu","volume":"242 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74489937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.53106/172674042023082102006
徐睿忻 徐睿忻, 鄭靜宜 鄭靜宜, 劉蕙婷 Ching-I Cheng
本文探討一位末期腎病於門診長期追蹤，突發心臟問題導致腎功能急速惡化，需長期透析治療之病人，面對健康狀況改變引發抉擇衝突之護理過程。於2020.12.15至2021.01.06，藉由觀察、會談、Gordon 11項功能性健康型態及身體評估等方式收集資料，歸納病人有抉擇衝突、營養少於身體所需、潛在危險性感染、及知識缺失之健康問題。過程中予以鼓勵、傾聽、支持，提供多元化衛教方式，增加對透析的認識，以醫病共享決策（Shared Decision Making, SDM）介入，協助病人依照意願選擇腹膜透析，成功學會居家治療方式及自我照顧。建議日後慢性腎臟病於門診追蹤時，醫護團隊提早計畫性介入SDM，提供相關識能及足夠時間讓病人及家屬做討論，及早思考，接受治療。 The nursing process of a patient facing conflicting choices caused by changes in health status who had chronic kidney disease with regular follow-up in an outpatient clinic and suddenly got cardiac problem leading to a rapid deterioration of renal function and thus required long-term dialysis treatment. From December 15th, 2020 to January 1st, 2021, the relevant data was collected through observation, interviews, and physical assessment by Gordon’s 11 Functional Health Patterns and conclude that this case have healthy issues of conflicting choices, less nutrition than physical needs, potentially dangerous infections, and knowledge deficit. In the process, nursing cares were provided through encouragement, listening, supporting, and providing diversified health education methods to increase knowledge of dialysis. Use shared decision making (SDM) to intervene and assist the patient to choose peritoneal dialysis according to personal wishes, and help the patient successfully learn home dialysis and self-care. In the future, it is recommended that when chronic kidney disease patients are follow-up in outpatient clinics, the medical team should plan in advance to intervene with SDM to provide relevant knowledge and leave enough time for patients and their families to discuss and think early for receiving treatment.
本文探讨一位末期肾病于门诊长期追踪，突发心脏问题导致肾功能急速恶化，需长期透析治疗之病人，面对健康状况改变引发抉择冲突之护理过程。于2020.12.15至2021.01.06，借由观察、会谈、Gordon 11项功能性健康型态及身体评估等方式收集资料，归纳病人有抉择冲突、营养少于身体所需、潜在危险性感染、及知识缺失之健康问题。过程中予以鼓励、倾听、支持，提供多元化卫教方式，增加对透析的认识，以医病共享决策（Shared Decision Making, SDM）介入，协助病人依照意愿选择腹膜透析，成功学会居家治疗方式及自我照顾。建议日后慢性肾脏病于门诊追踪时，医护团队提早计划性介入SDM，提供相关识能及足够时间让病人及家属做讨论，及早思考，接受治疗。 The nursing process of a patient facing conflicting choices caused by changes in health status who had chronic kidney disease with regular follow-up in an outpatient clinic and suddenly got cardiac problem leading to a rapid deterioration of renal function and thus required long-term dialysis treatment. From December 15th, 2020 to January 1st, 2021, the relevant data was collected through observation, interviews, and physical assessment by Gordon’s 11 Functional Health Patterns and conclude that this case have healthy issues of conflicting choices, less nutrition than physical needs, potentially dangerous infections, and knowledge deficit. In the process, nursing cares were provided through encouragement, listening, supporting, and providing diversified health education methods to increase knowledge of dialysis. Use shared decision making (SDM) to intervene and assist the patient to choose peritoneal dialysis according to personal wishes, and help the patient successfully learn home dialysis and self-care. In the future, it is recommended that when chronic kidney disease patients are follow-up in outpatient clinics, the medical team should plan in advance to intervene with SDM to provide relevant knowledge and leave enough time for patients and their families to discuss and think early for receiving treatment.
{"title":"運用共享決策照護一位末期腎病病人面對透析模式選擇之護理經驗","authors":"徐睿忻 徐睿忻, 鄭靜宜 鄭靜宜, 劉蕙婷 Ching-I Cheng","doi":"10.53106/172674042023082102006","DOIUrl":"https://doi.org/10.53106/172674042023082102006","url":null,"abstract":"\u0000 本文探討一位末期腎病於門診長期追蹤，突發心臟問題導致腎功能急速惡化，需長期透析治療之病人，面對健康狀況改變引發抉擇衝突之護理過程。於2020.12.15至2021.01.06，藉由觀察、會談、Gordon 11項功能性健康型態及身體評估等方式收集資料，歸納病人有抉擇衝突、營養少於身體所需、潛在危險性感染、及知識缺失之健康問題。過程中予以鼓勵、傾聽、支持，提供多元化衛教方式，增加對透析的認識，以醫病共享決策（Shared Decision Making, SDM）介入，協助病人依照意願選擇腹膜透析，成功學會居家治療方式及自我照顧。建議日後慢性腎臟病於門診追蹤時，醫護團隊提早計畫性介入SDM，提供相關識能及足夠時間讓病人及家屬做討論，及早思考，接受治療。\u0000 The nursing process of a patient facing conflicting choices caused by changes in health status who had chronic kidney disease with regular follow-up in an outpatient clinic and suddenly got cardiac problem leading to a rapid deterioration of renal function and thus required long-term dialysis treatment. From December 15th, 2020 to January 1st, 2021, the relevant data was collected through observation, interviews, and physical assessment by Gordon’s 11 Functional Health Patterns and conclude that this case have healthy issues of conflicting choices, less nutrition than physical needs, potentially dangerous infections, and knowledge deficit. In the process, nursing cares were provided through encouragement, listening, supporting, and providing diversified health education methods to increase knowledge of dialysis. Use shared decision making (SDM) to intervene and assist the patient to choose peritoneal dialysis according to personal wishes, and help the patient successfully learn home dialysis and self-care. In the future, it is recommended that when chronic kidney disease patients are follow-up in outpatient clinics, the medical team should plan in advance to intervene with SDM to provide relevant knowledge and leave enough time for patients and their families to discuss and think early for receiving treatment.\u0000 \u0000","PeriodicalId":31271,"journal":{"name":"Tai Wan Jiao Yu She Hui Xue Yan Jiu","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75226283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.53106/172674042023082102002
謝家恩 謝家恩, 呂宜潞 Chia-En Hsieh
本文個案因透析低血壓影響生活，感到失去對身體的控制感，加上長期慢性病與需終生依賴透析產生無望感引起筆者動機。筆者於2019年9月2日至10月28日護理期間，運用Gordon十一項功能性健康評估工具，收集主、客觀資料，確立個案有體液容積過量、便秘及無望感的健康問題。在生理層面讓個案瞭解適當攝水量之計算，並每日測量體重，有效控制兩次透析間增加的體重，使用藥物及非藥物的方式，協助個案養成每日排便的習慣；在心理層面以貝克無望感量表作為評估工具，運用家庭支持、腎友經驗分享，協助個案面對血液透析帶來的挑戰，建立有效策略面對疾病，提升個案對生活的控制感並積極參與治療，成功適應血液透析的生活，並表達對未來的期待與規劃。 This article describes the patient’s poor quality of life owing to hemodialysis hypotension. He felt a sense of loss of motor control. Because of his chronic disease that mandated continued hemodialysis, the patient felt hopeless. Have caused the author’s motivation. During the nursing period from September 2 to October 28, 2019, the author used Gordon’s 11 functional health assessment tools to collect subjective and objective data to establish the patient’s health complications, such as excess fluid volume, constipation, and hopelessness. For physiological improvement, the patient was educated of water intake regulation, daily weight measurement for effective weight control between 2 dialysis sessions, and use of drug- and non-drug methods to help develop a daily bowel habit. For psychological support, the Beck Hopelessness Scale was used as a mental state assessment tool. Family support and nephrologist’s sharing of their experience were used to help the patient overcome the challenges from hemodialysis. Basis this study, we recommend establishing effective strategies to cope with disease, improving the individual’s sense of control over life and encouraging active participation in treatment, successfully adapting to the changes in daily life effected by hemodialysis, and expressing expectations and plans for the future.
本文个案因透析低血压影响生活，感到失去对身体的控制感，加上长期慢性病与需终生依赖透析产生无望感引起笔者动机。笔者于2019年9月2日至10月28日护理期间，运用Gordon十一项功能性健康评估工具，收集主、客观资料，确立个案有体液容积过量、便秘及无望感的健康问题。在生理层面让个案了解适当摄水量之计算，并每日测量体重，有效控制两次透析间增加的体重，使用药物及非药物的方式，协助个案养成每日排便的习惯；在心理层面以贝克无望感量表作为评估工具，运用家庭支持、肾友经验分享，协助个案面对血液透析带来的挑战，建立有效策略面对疾病，提升个案对生活的控制感并积极参与治疗，成功适应血液透析的生活，并表达对未来的期待与规划。 This article describes the patient’s poor quality of life owing to hemodialysis hypotension. He felt a sense of loss of motor control. Because of his chronic disease that mandated continued hemodialysis, the patient felt hopeless. Have caused the author’s motivation. During the nursing period from September 2 to October 28, 2019, the author used Gordon’s 11 functional health assessment tools to collect subjective and objective data to establish the patient’s health complications, such as excess fluid volume, constipation, and hopelessness. For physiological improvement, the patient was educated of water intake regulation, daily weight measurement for effective weight control between 2 dialysis sessions, and use of drug- and non-drug methods to help develop a daily bowel habit. For psychological support, the Beck Hopelessness Scale was used as a mental state assessment tool. Family support and nephrologist’s sharing of their experience were used to help the patient overcome the challenges from hemodialysis. Basis this study, we recommend establishing effective strategies to cope with disease, improving the individual’s sense of control over life and encouraging active participation in treatment, successfully adapting to the changes in daily life effected by hemodialysis, and expressing expectations and plans for the future.
{"title":"照顧一位血液透析病人無望感之護理經驗","authors":"謝家恩 謝家恩, 呂宜潞 Chia-En Hsieh","doi":"10.53106/172674042023082102002","DOIUrl":"https://doi.org/10.53106/172674042023082102002","url":null,"abstract":"\u0000 本文個案因透析低血壓影響生活，感到失去對身體的控制感，加上長期慢性病與需終生依賴透析產生無望感引起筆者動機。筆者於2019年9月2日至10月28日護理期間，運用Gordon十一項功能性健康評估工具，收集主、客觀資料，確立個案有體液容積過量、便秘及無望感的健康問題。在生理層面讓個案瞭解適當攝水量之計算，並每日測量體重，有效控制兩次透析間增加的體重，使用藥物及非藥物的方式，協助個案養成每日排便的習慣；在心理層面以貝克無望感量表作為評估工具，運用家庭支持、腎友經驗分享，協助個案面對血液透析帶來的挑戰，建立有效策略面對疾病，提升個案對生活的控制感並積極參與治療，成功適應血液透析的生活，並表達對未來的期待與規劃。\u0000 This article describes the patient’s poor quality of life owing to hemodialysis hypotension. He felt a sense of loss of motor control. Because of his chronic disease that mandated continued hemodialysis, the patient felt hopeless. Have caused the author’s motivation. During the nursing period from September 2 to October 28, 2019, the author used Gordon’s 11 functional health assessment tools to collect subjective and objective data to establish the patient’s health complications, such as excess fluid volume, constipation, and hopelessness. For physiological improvement, the patient was educated of water intake regulation, daily weight measurement for effective weight control between 2 dialysis sessions, and use of drug- and non-drug methods to help develop a daily bowel habit. For psychological support, the Beck Hopelessness Scale was used as a mental state assessment tool. Family support and nephrologist’s sharing of their experience were used to help the patient overcome the challenges from hemodialysis. Basis this study, we recommend establishing effective strategies to cope with disease, improving the individual’s sense of control over life and encouraging active participation in treatment, successfully adapting to the changes in daily life effected by hemodialysis, and expressing expectations and plans for the future.\u0000 \u0000","PeriodicalId":31271,"journal":{"name":"Tai Wan Jiao Yu She Hui Xue Yan Jiu","volume":"138 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74801167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.53106/172674042023082102003
呂靜宜 呂靜宜, 郭佳薰 郭佳薰
本文描述一位罹患末期腎病變之青少年接受腎臟移植手術的護理經驗。筆者於2019年1月6日至1月30日護理期間，運用身、心、靈、社會整體性評估，確認個案有急性疼痛、焦慮、潛在危險性感染及知識缺失等健康問題。 在疼痛方面，除教導使用固定帶固定傷口和使用別針固定引流管避免拉扯外，並鼓勵採深呼吸放鬆等技巧，以轉移疼痛的注意力；在執行護理活動前均詳細說明步驟與目的，並使用通訊軟體參與病友團體討論，藉由正向經驗分享，來增加對未來生活的信心並降低焦慮感；此外也指導傷口照護、協助認識感染徵兆及瞭解配戴口罩和勤洗手的重要，以降低危險性感染。最後，與個案共同訂定學習目標、提升移植術後自我照顧知識和增進其對藥物的瞭解及記憶，並鼓勵養成良好生活習慣、提醒按時回診追蹤，最終使問題獲得解決。期望藉此經驗分享提供臨床照護參考。 This article describes a nursing experience of a teenager with end-stage renal disease who successfully underwent kidney transplantation. During the nursing period from January 6 to January 30, 2019, the author confirmed that the patient had health problems of acute pain, anxiety, potential risks for infection, and a lack of knowledge through holistic assessments. The care processes for reducing his pain perception included the use of tapes or pins to fix the wound and drainage tubes and ways to divert attention from pain. In terms of lowering his anxiety, we explained the purpose and process comprehensively before each nursing care. In addition, we encouraged him to use communication software to participate in group discussions and share positive experiences to increase confidence for future life. We also educated the patient on how to reduce the risk of infection by performing good wound care, recognizing early signs of infection, and understanding the importance of wearing a mask and washing his hands frequently. Finally, we set the same learning goals together, enhanced his knowledge and memory of immunosuppressive drugs, encouraged good living habits, and reminded him to return to the outpatient department on time, eventually solving the problems. We want to share these experiences to provide a reference for clinical care.
本文描述一位罹患末期肾病变之青少年接受肾脏移植手术的护理经验。笔者于2019年1月6日至1月30日护理期间，运用身、心、灵、社会整体性评估，确认个案有急性疼痛、焦虑、潜在危险性感染及知识缺失等健康问题。在疼痛方面，除教导使用固定带固定伤口和使用别针固定引流管避免拉扯外，并鼓励采深呼吸放松等技巧，以转移疼痛的注意力；在执行护理活动前均详细说明步骤与目的，并使用通讯软体参与病友团体讨论，借由正向经验分享，来增加对未来生活的信心并降低焦虑感；此外也指导伤口照护、协助认识感染征兆及了解配戴口罩和勤洗手的重要，以降低危险性感染。最后，与个案共同订定学习目标、提升移植术后自我照顾知识和增进其对药物的了解及记忆，并鼓励养成良好生活习惯、提醒按时回诊追踪，最终使问题获得解决。期望借此经验分享提供临床照护参考。 This article describes a nursing experience of a teenager with end-stage renal disease who successfully underwent kidney transplantation. During the nursing period from January 6 to January 30, 2019, the author confirmed that the patient had health problems of acute pain, anxiety, potential risks for infection, and a lack of knowledge through holistic assessments.The care processes for reducing his pain perception included the use of tapes or pins to fix the wound and drainage tubes and ways to divert attention from pain. In terms of lowering his anxiety, we explained the purpose and process comprehensively before each nursing care. In addition, we encouraged him to use communication software to participate in group discussions and share positive experiences to increase confidence for future life. We also educated the patient on how to reduce the risk of infection by performing good wound care, recognizing early signs of infection, and understanding the importance of wearing a mask and washing his hands frequently. Finally, we set the same learning goals together, enhanced his knowledge and memory of immunosuppressive drugs, encouraged good living habits, and reminded him to return to the outpatient department on time, eventually solving the problems. We want to share these experiences to provide a reference for clinical care.
{"title":"照護一位末期腎病變青少年接受腎臟移植手術之護理經驗","authors":"呂靜宜 呂靜宜, 郭佳薰 郭佳薰","doi":"10.53106/172674042023082102003","DOIUrl":"https://doi.org/10.53106/172674042023082102003","url":null,"abstract":"本文描述一位罹患末期腎病變之青少年接受腎臟移植手術的護理經驗。筆者於2019年1月6日至1月30日護理期間，運用身、心、靈、社會整體性評估，確認個案有急性疼痛、焦慮、潛在危險性感染及知識缺失等健康問題。\u0000在疼痛方面，除教導使用固定帶固定傷口和使用別針固定引流管避免拉扯外，並鼓勵採深呼吸放鬆等技巧，以轉移疼痛的注意力；在執行護理活動前均詳細說明步驟與目的，並使用通訊軟體參與病友團體討論，藉由正向經驗分享，來增加對未來生活的信心並降低焦慮感；此外也指導傷口照護、協助認識感染徵兆及瞭解配戴口罩和勤洗手的重要，以降低危險性感染。最後，與個案共同訂定學習目標、提升移植術後自我照顧知識和增進其對藥物的瞭解及記憶，並鼓勵養成良好生活習慣、提醒按時回診追蹤，最終使問題獲得解決。期望藉此經驗分享提供臨床照護參考。\u0000 This article describes a nursing experience of a teenager with end-stage renal disease who successfully underwent kidney transplantation. During the nursing period from January 6 to January 30, 2019, the author confirmed that the patient had health problems of acute pain, anxiety, potential risks for infection, and a lack of knowledge through holistic assessments.\u0000The care processes for reducing his pain perception included the use of tapes or pins to fix the wound and drainage tubes and ways to divert attention from pain. In terms of lowering his anxiety, we explained the purpose and process comprehensively before each nursing care. In addition, we encouraged him to use communication software to participate in group discussions and share positive experiences to increase confidence for future life. We also educated the patient on how to reduce the risk of infection by performing good wound care, recognizing early signs of infection, and understanding the importance of wearing a mask and washing his hands frequently. Finally, we set the same learning goals together, enhanced his knowledge and memory of immunosuppressive drugs, encouraged good living habits, and reminded him to return to the outpatient department on time, eventually solving the problems. We want to share these experiences to provide a reference for clinical care.","PeriodicalId":31271,"journal":{"name":"Tai Wan Jiao Yu She Hui Xue Yan Jiu","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86064059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.53106/172674042023082102004
陳麗君 陳麗君, 蔡麗華 Li-Chun Chen
本文探討一位血液透析個案，面臨配偶重症失能又肩負照護責任，所引發生、心理及社會問題，護理期間為2019年1月23日至2019年4月15日，依四大層面進行整體性護理評估，經由行為觀察、會談，身體評估及病歷查閱等方式收集資料，歸納出個案有恐懼、營養狀況改變、照顧者緊張等護理問題。傾聽個案的不安與恐懼，引導個案求助於自身信仰達到心靈的安適，並同理不遵守足量透析之決定，評估家庭關係，鼓勵家人參與照護，醫療端配合調整透析時段及地點轉換，讓透析治療不再是一種無法變動的限制，進而改善其飲食及透析狀況，提升透析品質，並連結跨部門及社會團體提供協助，調整生活作息，減緩照顧壓力與緊張，讓個案勝任角色改變之衝擊。 This article investigated the related mental, physiological and social issues of a dialysis patient who bears the responsibility for taking care of a disabled spouse. The nursing care period of the subject was from January 23 to April 15 of 2019. Nursing assessment was performed according to the four dimensions of patient status; data collection was conducted through behavior observations, interviews, physiological evaluation and medical record review. The results showed that the subject was suffering with issues like fear, change in nutrition status and caregiver stress. To assist the subject, we first listened to the fear and anxiety expressed by the subject and then guided the subject to seek spiritual comfort through personal faith. We empathized with the subject’s decision to not adhere to dialysis adequacy and evaluated the subject’s family relationship to identify causes and encourage participation of family members in the care process. On the medical service side, we adjusted the dialysis time periods and changed locations to allow flexibility in dialysis treatment; we then gradually improved the diets of the subject and dialysis conditions to increase the quality of the dialysis. Finally, we worked closely between departments and social welfare societies to provide necessary assistance and adjusted the living habits of the subject to reduce the stress and anxiety related to caregiving, allowing the subject to adjust to the impact of role change.
本文探讨一位血液透析个案，面临配偶重症失能又肩负照护责任，所引发生、心理及社会问题，护理期间为2019年1月23日至2019年4月15日，依四大层面进行整体性护理评估，经由行为观察、会谈，身体评估及病历查阅等方式收集资料，归纳出个案有恐惧、营养状况改变、照顾者紧张等护理问题。倾听个案的不安与恐惧，引导个案求助于自身信仰达到心灵的安适，并同理不遵守足量透析之决定，评估家庭关系，鼓励家人参与照护，医疗端配合调整透析时段及地点转换，让透析治疗不再是一种无法变动的限制，进而改善其饮食及透析状况，提升透析品质，并连结跨部门及社会团体提供协助，调整生活作息，减缓照顾压力与紧张，让个案胜任角色改变之冲击。 This article investigated the related mental, physiological and social issues of a dialysis patient who bears the responsibility for taking care of a disabled spouse. The nursing care period of the subject was from January 23 to April 15 of 2019. Nursing assessment was performed according to the four dimensions of patient status; data collection was conducted through behavior observations, interviews, physiological evaluation and medical record review. The results showed that the subject was suffering with issues like fear, change in nutrition status and caregiver stress. To assist the subject, we first listened to the fear and anxiety expressed by the subject and then guided the subject to seek spiritual comfort through personal faith. We empathized with the subject’s decision to not adhere to dialysis adequacy and evaluated the subject’s family relationship to identify causes and encourage participation of family members in the care process.On the medical service side, we adjusted the dialysis time periods and changed locations to allow flexibility in dialysis treatment; we then gradually improved the diets of the subject and dialysis conditions to increase the quality of the dialysis. Finally, we worked closely between departments and social welfare societies to provide necessary assistance and adjusted the living habits of the subject to reduce the stress and anxiety related to caregiving, allowing the subject to adjust to the impact of role change.
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