臨牀透析 Vol.31 No.11(6-2)


特集名 透析患者とその家族で取り組む合併症予防
題名 メンタルヘルス (2) 維持透析期および「透析終末期」
発刊年月 2015年 10月
著者 堀川 直史 埼玉医科大学かわごえクリニックメンタルヘルス科
【 要旨 】 維持透析期における患者のメンタルヘルスの問題は近年ますます重要になってきている.透析を含む新しい生活における自分の立場と価値をもう一度作り上げることが維持透析期の患者の課題であり,これに関係してさまざまな心理的問題や精神症状,さらに家族関係の問題が生じる.家族関係の問題への対応では,患者の社会的役割と家族内の立場に関する変化の十分な理解が重要であり,この理解を通して協力的な治療関係が生まれ,その後の相談が進みやすくなる.家族に対しても,心理的治療とケアを行うことが必要な場合もある.「透析終末期」は維持透析期とさまざまな点で異なる.透析終末期における患者と家族の心理,心理的治療とケアは今後の重要な検討課題である.
Theme Approach for preventing dialysis-related complications in dialysis patients and their family
Title Mental health of maintenance hemodialysis and terminal stage of hemodialysis therapy patients
Author Naoshi Horikawa Department of Psychiatry, Kawagoe Clinic, Saitama Medical University
[ Summary ] The mental health problems of those patients undergoing maintenance hemodialysis have become increasingly important in recent years. Those patients have the task of reconstructing attitudes in line with their own sense of values in new life styles, including hemodialysis. In accomplishing this task, there are various psychological problems, including family related issues. In relation to dealing with family related problems, we must fully understand the changes in patients' social roles and their position in their families. Through this understanding, collaborative doctor patient relationships may be founded. In addition, psychological therapy and care for patients' family members are often necessary. The characteristics of "terminal stage dialysis therapy" are different from those of ordinary maintenance dialysis in various aspects. Thus, it is essential to examine the psychology of the terminal stage hemodialysis patients and their family members, and to evaluate the effectiveness of psychological therapy to care for these patients.
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