臨牀透析 Vol.30 No.14(4-1)


特集名 在宅透析2014 ― HHDとPD
題名 HHD:在宅血液透析の現状と最新技術 (1) 患者のトレーニング方法
発刊年月 2014年 12月
著者 宮下 美子 新生会第一病院看護部・看護師
著者 澤村 美海 新生会第一病院在宅透析教育センター・看護師
【 要旨 】 在宅血液透析(HHD)トレーニングを始める前にHHDに携わる各医療者が面接し受け入れ可能か判断する.個別性を重視した教育・指導を工夫し,患者・介助者がモチベーションを維持しながら技術習得を目指す.安全なHHDを行うため危機感をもてるように,モデルや体験を通してトラブル対処法の指導を行う.患者・介助者とともに技術面での課題を明らかにして繰り返し練習したり,課題を緩和する対策を工夫してHHDをスタートさせる.不十分な技術は継続教育で補う.技術習得がスムーズにいかなくても患者・介助者に合わせた工夫をすることでHHDへ移行できる.
Theme Home dialysis 2014 -- HHD and PD
Title Training methods for home hemodialysis patients
Author Yoshiko Miyashita Department of Nursing, Shinseikai Dai-ichi Hsopital
Author Yoshimi Sawamura HHD and CAPD Center, Shinseikai Dai-ichi Hsopital
[ Summary ] Medical treatment for individuals involved in home hemodialysis (HHD) include HHD training, which starts with interviews to determine acceptable patients. Educational guidance concerning the values of individuals is devised. Patients and their families must aim for technological skills acquisition while maintaining their motivation. With the sense of crisis having been eliminated because of safe HHD implementation, treatment methods must be guided by empirical models. HHD must be started by clarifying the technical problems experienced by patients and their families and repeatedly devising measures to ease those problems. Insufficient technology may be supplemented with continuing education and training. It is possible to shift to HHD by providing devices matched to individual patients and their families even when technological acquisition is not achieved.
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