臨牀透析 Vol.33 No.10(4-1)


特集名 維持透析患者の喪失感―理解・克服への支援
題名 透析医・移植医が経験する透析患者の喪失感(1)透析開始後中期・長期患者
発刊年月 2017年 09月
著者 平松 信 岡山済生会総合病院腎臓病・糖尿病総合医療センター
【 要旨 】 透析患者は,それまで大切にしていた大きなものを失う喪失感を抱きながら,透析とともに生きている.保存期腎不全期から透析導入が必要になる際の透析受容における苦悩を,透析医はまず理解するべきである.そして,体液状態の維持,栄養状態の改善などの臨床上のメリットのみならず,生命予後にも影響する残存腎機能(尿量)低下という喪失感,合併症などさまざまな因子によるQOLの低下という喪失感,加齢や疾病などによる認知能力低下という喪失感,導入時には保持されていた自立能力低下という喪失感,人生の最終段階の看取りにおける喪失感を,透析医は理解し,患者(家族)を支援する努力を惜しむべきではない.
Theme Sense of loss of dialysis patients -- support for understanding and overcoming
Title Feelings of loss experienced by a patient undergoing dialysis that a dialysis physician observes
Author Makoto Hiramatsu Department of Nephrology, Okayama Saiseikai General Hospital
[ Summary ] Dialysis patients are compelled to live with a feeling of loss of things that are vital/close to them. It is imperative that dialysis physicians understand the hardships/distress of the patient who must accept introduction of the dialysis procedure. As dialysis treatment progresses, patients experience a deeper sense of loss regarding the decline in remaining renal function (urine volume), which would influence their convalescence, a sense of loss regarding the decline in quality of life (QOL) related to various factors including complications, age- or illness-related deterioration in cognitive abilities, and an increasing loss of independence compared to the patient's independence levels at the time of introduction of dialysis, and loss of life itself in the terminal stages. Dialysis physicians should empathize with these feelings of loss experienced by dialysis patients and should support them and their families.
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