臨牀透析 Vol.30 No.12(2-3)


特集名 体重管理が困難な透析患者への支援
題名 体重管理困難事例への看護の挑戦!―個別性に応じた看護ケア― (3) 自尊感情に配慮した体重管理困難事例への実践―Professional Learning Climate(PLC)を基礎とした看護介入
発刊年月 2014年 10月
著者 大賀 由花 赤磐医師会病院・看護師
著者 竹内 京子 赤磐医師会病院・看護師
著者 川口 憲二 赤磐医師会病院
【 要旨 】 日本透析医学会は,最大透析間隔日の体重増加を6%未満にすることを推奨している.しかしそれを超える患者も多く,患者指導の際に,医療者はこのような患者に陰性感情を抱き,患者の自尊感情が低下する場面に遭遇することがある.今回,体重管理困難事例に対して,Professional Learning Climate(PLC)を基礎とし,患者の自尊感情を高める看護介入を行った.農業という労働に価値をおく地方の患者と,医療者の陰性感情における環境調整の重要性について示唆を得た.体重増加へのアプローチは,健康認識と生活における価値を見極めた関わりが必要である.
Theme Nursing care for dialysis patients having difficulty in body weight control
Title Dialysis nursing practice based on the Professional Learning Climate (PLC) to increase the self-esteem for weight management difficult case
Author Yuka Ohga Department of Nursing, Akaiwa Medical Association Hospital
Author Kyoko Takeuchi Department of Nursing, Akaiwa Medical Association Hospital
Author Kenji Kawaguchi Akaiwa Medical Association Hospital
[ Summary ] The Japanese Society for Dialysis Therapy recommends particular treatment modes for dialysis patients receiving every other day treatment. Weight gain of less than 6 % over predialysis status is recommended. However, many patients gain too much weight during treatment periods, which may cause the medical staff to become dispirited. The self-esteem of patients may be decreased as well. This short report, dealing with weight management in these difficult cases is based on professional learning climate (PLC). It was performed trough nursing intervention with the goal of increasing the self-esteem of patients. The research was performed in rural settings to achieve information concerning patients' positive adjustments to farm work, despite the negative feelings possibly exhibited by the medical staff to the patient. It is necessary to assess the value of life and health perception involved when approaching the issue of weight gain in patients with chronic renal failure.
戻る