| 特集名 | ハイテク時代における看護の統合 | |
|---|---|---|
| 題名 | CAPD装置の進歩と看護 -- APDの併用と患者のQOL | |
| 発刊年月 | 1999年 10月 | |
| 著者 | 渡邊 由紀子 | 岡山済生会総合病院腎臓病センター・看護婦 |
| 著者 | 三上 裕子 | 岡山済生会総合病院腎臓病センター・看護婦 |
| 著者 | 平松 信 | 岡山済生会総合病院腎臓病センター内科 |
| 【 要旨 】 | 自己管理できていたCAPD患者も加齢・合併症等に伴い，家族の介護を要する症例が増えてきている．今回，われわれは介護者の負担の軽減を目的に，自動腹膜灌流装置(APD)を併用した1症例を経験しその有用性を検討した． APDを併用することで介護者の心理的・時間的負担は軽減でき，除水・透析効率は十分維持できていた．APDシステムを取り入れた症例には，社会復帰を目的にしたものと，透析・除水不足，カルシウム・リンのコントロール不良，腰痛，腹膜炎対策を目的とした二通りがあるが，本症例のように家族の介護負担を軽減し，QOLの向上をはかるためにもAPDの併用は有効であると考えられる． |
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| Theme | Integration of Nursing Task on the Times of High Technology | |
|---|---|---|
| Title | Improvement of CAPD exchange system and nursing -- utilization of APD and QOL | |
| Author | Yukiko Watanabe | Department of Nursing, Okayama Saiseikai General Hospital |
| Author | Hiroko Mikami | Department of Nursing, Okayama Saiseikai General Hospital |
| Author | Makoto Hiramatsu | Department of Nephrology, Okayama Saiseikai General Hospital |
| [ Summary ] | The number of CAPD patients requiring nursing care from their families, because they could not take care of themselves, due to complications associated with aging, has increased recently. We examined one case in which an APD system was used, along with CAPD, to reduce the burden on the nursing family and considered the efficacy of this treatment. The patient was a seventy one-year-old male, using CAPD for treatment of diabetes mellitus. The decrease of appendicular myodynamia and the reduction of visual acuity, caused by diabetic complications, made it impossible for him to change bags. Moreover, the loss of ultrafiltration made it necessary for his wife to change bags six times per day. The utilization of the APD system, along with CAPD, could reduce the burden on the nursing provider, not only from a psychological standpoint, but also in terms of time required for patient care for ultrafiltration and uremic solute clearance. There are two major purpose for utilization of an APD system. The first is the lifestyle benefits. The second is the prevention of problems associated with dialysis, such as inadequate ultrafiltration or uremic solute clearance, inadequate control of calcium or phosphorus, back pain, peritonitis, etc. From the observations made in this case we concluded that the utilization of APD systems may reduce stress related nursing and improve overall QOL. |
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