To Explore the Worries, Hope, Feelings, and Needs on Hemodialysis Patients

• Main Authors: Chiung-Yu Shih, 施瓊玉
• Other Authors: Fu-In Tang
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/56631910906848458971

碩士 === 國立陽明大學 === 護理學系 === 100 === End-stage renal disease ( ESRD ) not only threatens people's health and quality of life, but also lead to high cost of health insurance and increased demand of medical faculty. In Taiwan, the major treatment modality of ESRD is hemodialysis, which accounts for 89.7% of ESRD patients. The purpose of this study is to investigate 1. the difference of the worries which hemodialysis brings,2.the discrepancy of hope in hemodialysis patients, 3. the different needs including physical, mental, spiritual needs, and the service needs of medical workers,4. the difference of feelings after hemodialysis.This research is a cross-sectional study, and designed as a self-structured questionnaire for investigation. Questionnaires contain Worries Scale, Hope Scale, Feelings Scale, and Needs Scale, which include physical needs, psychological needs, spiritual needs, and the service needs of medical workers. We choose one outpatient hemodialysis unit of the medical center in Taipei, with a total enrollment of 159 patients. The face-to-face interviews were performed by researchers after the dialysis treatment. Overall content validity index value of the questionnaires was 0.91, and Cronbach α value of the reliability test was 0.95. The results showed that average score of worries of hemodialysis patients was ( 2.9±0.9 ), and the most troubling problem was long-term life dependent machine. Hemodialysis patients had high average score of hope ( 4.2±0.6 ), and the most hope problem was that the dialysis course could remove excess water and toxins, and the hemodialysis course would be safe and smooth. The average score of feelings was ( 3.2±0.5 ), and the greatest feeling was to successfully complete each hemodialysis treatment. Besides, average scores of needs were as follows: medical service needs ( 4.1±0.7 ), physiological needs ( 4.0±0.8 ), psychological needs ( 3.2±0.8 ), other needs ( 3.1±0.9 ) and spiritual needs ( 2.7±1.0 ). What the most needs of the dialysis patients included of increased drug payment of health insurance, provision of better dialysis equipment, friendly and skilled medical staff, smooth course of the needle puncture, careful attention on the whole dialysis treatment, avoidance of low blood pressure and other discomfort symptoms while hemodialysis. The relationship between these four scales and the basic characteristics of all patients showed that high physical needs were related to those whose financial sources are provided by their families; high psychological, spiritual, and other needs were related to those who have jobs; high spiritual and other needs were related to college education, self-care capabilities and no religious beliefs; high other needs was related to people who have 1 to 2 children; no special factor was related to service needs of medical workers. We also found that the more scores of hope was related to the more scores of worries and needs scales, and vice versa. In conclusion, this study showed that the hemodialysis affects the patients' worries, hope, feelings and the different needs. In order to set up a safe hemodialysis environment, medical workers must enhance their clinical skill, assist the dialysis patients in relieving their discomfort, worries, and anxiety, teach the patients how to face their lives with a positive attitude, improve dialysis patients' quality of life and further holistic health care. The results could be as reference to study patient’s worries, hope, feelings, and needs of hemodialysis applied to other hemodialysis units, to improve their healthcare quality.