| 特集名 | 臨床検査値から栄養管理への展開 | |
|---|---|---|
| 題名 | 栄養管理面の看護婦の関わり | |
| 発刊年月 | 2001年 11月 | |
| 著者 | 青山 節子 | 前田記念腎研究所武蔵小杉クリニック・看護婦 |
| 著者 | 海老塚 典子 | 前田記念腎研究所武蔵小杉クリニック・看護婦 |
| 著者 | 外間 文子 | 前田記念腎研究所武蔵小杉クリニック・管理栄養士 |
| 著者 | 福内 史子 | 前田記念腎研究所武蔵小杉クリニック内科 |
| 著者 | 前田 貞亮 | 前田記念腎研究所武蔵小杉クリニック内科 |
| 【 要旨 】 | 透析療法は透析効率の改善において大きく進歩し，新しい薬物療法も登場している．しかしながら，その機能は未だ完全ではなく，生体のもつ腎臓機能を完全に代償はしえない．身体的な苦痛や将来起こりうる合併症を予防し，良好な予後を送るためには食事療法は必要不可欠である． 本稿では透析に関する病識に乏しく，体重管理不良な糖尿病性腎症患者の症例をもとに，看護婦の行う食事指導について述べた． この患者は，シャント閉塞を機に自己管理の重要性を強く認識したが，それ以前にわれわれの指導を通じて病識が芽生えてきていた背景があった．導入後まだ1年に満たず，透析療法を受容できていない患者が食事管理の意義を認識し透析生活に対応できるようになるためには，看護婦がまず患者をあらゆる面から理解し，精神的な支援，辛抱強い受容的態度をもった関わりが必要である． |
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| Theme | Expanding Clinical Experimental Findings for Nutritional Management | |
|---|---|---|
| Title | Nursing consultation and communication with dialysis patients undergoing diet therapy | |
| Author | Setsuko Aoyama | Maeda Institute of Renal Research Musashi Kosugi Clinic |
| Author | Noriko Ebizuka | Maeda Institute of Renal Research Musashi Kosugi Clinic |
| Author | Ayako Hokama | Maeda Institute of Renal Research Musashi Kosugi Clinic |
| Author | Fumiko Fukuuchi | Maeda Institute of Renal Research Musashi Kosugi Clinic |
| Author | Teiryo Maeda | Maeda Institute of Renal Research Musashi Kosugi Clinic |
| [ Summary ] | Renal replacement therapy has made great progress in the efficiency of dialysis treatment and new improved medication is indicated. Although it plays a vital role, dialysis is not a perfect therapy and does not provide the level of functionallity, does the natural kidney. In order to prevent any discomfort or complications in the future and to provide good prognoses, diet therapy is indispensable. In this paper, nursing consultation on diet therapy is noted with the example of a diabetic hemodialysis patient with poor control and weight gain during the interval of dialysis treatment, caused by poor understanding of her disease. This patient has experienced a vascular access occlusion, which by chance and raised her consciousness of the necessity of self control. Before this accident, her poor awareness of her condition was being improving through communication and consultation. In this case, less than one year after dialysis introduction, the patient could not fully accept her life under dialysis. It was difficult make her understand the importance of diet therapy. Nutritional consultation, with psychological support for her life as a dialysis patient was continued by nurses until she was able to understand. It is required that nurses consult patients in an on-going fashion with maximum. |
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